소아와 청소년기에 발생한 하시모토 갑상샘염과 Hashitoxicosis의 임상적 경과에 대한 연구

Abstract

Objective: The purpose is to study the natural course and clinical feature according to thyroid function at diagnosis of Hashimoto’s thyroiditis in children and adolescent. We studied to know the difference of clinical finding and change of thyroid autoantibody titers between Hashitoxicosis and typical Hashimoto’s thyroiditis. Methods: We analyzed retrospectively clinical data in 55 patients diagnosed as Hashimoto’s thyroiditis. 47 were followed for more than 2 years and they were classified into euthyroid, compensated hypothyroidism, overt hypothyroidism, and hyperthyroidism according to thyroid hormone status at diagnosis. We investigated age, family history, initial thyroid function, initial thyroid autoantibody titers, changes of thyroid function, and changes of thyroid autoantibody titers. Results: At diagnosis, 10 of 47 patients were in euthyroid, 17 in compensated hypothyroidism, 17 in overt hypothyroidism and 3 in hyperthyroidism. There was no statistically significant difference in the clinical data among the 4 groups of patients. Among the 47patients, 4 patients had presented Hashitoxicosis. These patients’ characteristics were similar to the patients with typical Hashimoto’s thyroiditis. They had variable duration of hyperthyroidism range from 3 months to 5 years. It was possible to observe the rise of autoantibody titers from the patients with Hashitoxicosis when thyroid function was shifted to hypothyroidism. However it was not statistically significant. Conclusion: The clinical progress of Hashimoto’s thyroiditis and hashitoxicosis varied widely. It is necessary to conduct more researches on the occurrence of Hashitoxicosis and the association with the change of autoantibodies on the patients with Hashimoto’s thyroiditis.