Segni M, Wood J, Pucarelli I, Toscano V, Toscano R, Pasquino A M
Department of Pediatrics, La Sapienza University, Rome, Italy.
J Pediatr Endocrinol Metab. 2001;14 Suppl 5:1271-5; discussion 1297-8.
Autoimmune thyroid diseases (AITD) are known to be clustered in families, but to what extent this occurs in childhood and adolescence is not well defined. In order to establish the prevalence of AITD in the siblings of affected children and adolescents, we examined 73 siblings from 66 families selected on the basis of a pediatric index patient. Sixty-six families, including a total of 146 offspring, were selected on the basis of diagnosis of chronic lymphocytic thyroiditis (CLT) (n = 55) or Graves' disease (GD) (n = 11). Among the 73 siblings examined, 20 new cases of CLT (27%) were detected. L-Thyroxine therapy was required in 4/20. History of AITD was recorded in 24/66 mothers (36%), and in two fathers. Overall in these families, considering both the index patients and the new patients, 86/141 (61%) children and adolescents were affected with AITD, with a female/male ratio of 3.3:1. Our study confirms that AITD clusters in families with a high prevalence in the siblings of affected children and adolescents. These children should be followed in order to avoid undiagnosed hypothyroidism. Prospective studies are warranted to identify predictive factors for overt thyroid disease.
自身免疫性甲状腺疾病（AITD）在家族中具有聚集性，但在儿童期和青少年期的聚集程度尚不清楚。为了确定受影响儿童和青少年的兄弟姐妹中AITD的患病率，我们对66个家庭中的73名兄弟姐妹进行了检查，这些家庭是根据一名儿科索引患者挑选出来的。66个家庭，包括总共146名后代，是根据慢性淋巴细胞性甲状腺炎（CLT）（n = 55）或格雷夫斯病（GD）（n = 11）的诊断挑选出来的。在接受检查的73名兄弟姐妹中，检测到20例新的CLT病例（27%）。20例中有4例需要左旋甲状腺素治疗。66名母亲中有24名（36%）有AITD病史，两名父亲有AITD病史。在这些家庭中，总体而言，考虑到索引患者和新患者，141名儿童和青少年中有86名（61%）患有AITD，女性/男性比例为3.3:1。我们的研究证实，AITD在家族中具有聚集性，在受影响儿童和青少年的兄弟姐妹中患病率很高。应该对这些儿童进行随访，以避免未诊断的甲状腺功能减退症。有必要进行前瞻性研究以确定显性甲状腺疾病的预测因素。
