Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
Ital J Pediatr. 2018 Feb 7;44(1):22. doi: 10.1186/s13052-018-0461-5.
ᅟ: Aim of this commentary is to summarize the salient literature views on the relationships between presentation and evolution patterns of thyroid function in children with Hashimoto's thyroiditis (HT). According to the most recent reports, children with HT and subclinical hypothyroidism (SH) are more prone to the risk of developing severe thyroid dysfunctions over time, if compared to those presenting with euthyroidism. In contrast, children presenting with HT and either overt or subclinical hyperthyroidism are incline to exhibit a definitive resolution of the hyperthyroid phase within some months, although there is a wide variability between the different individuals. The natural history of frank hypothyroidism in the children with HT has never been investigated so far, since in these cases an immediate onset of replacement treatment is mandatory.
ᅟ:本评论的目的是总结有关桥本甲状腺炎(HT)儿童甲状腺功能表现和演变模式之间关系的重要文献观点。根据最近的报告,如果与表现为甲状腺功能正常的儿童相比,患有 HT 和亚临床甲状腺功能减退症(SH)的儿童随着时间的推移更容易发生严重甲状腺功能障碍的风险。相比之下,表现为显性或亚临床甲状腺功能亢进症的 HT 儿童更倾向于在几个月内明确缓解甲状腺功能亢进期,尽管不同个体之间存在很大的可变性。迄今为止,从未研究过 HT 儿童中真正的甲状腺功能减退症的自然病程,因为在这些情况下,必须立即开始替代治疗。
1)随着时间的推移,甲状腺功能可能会恶化,尤其是在表现为 SH 的儿童中,但也可能在表现为甲状腺功能正常的儿童中;2)在表现为显性或亚临床甲状腺功能亢进症的儿童中,甲状腺功能亢进期通常会得到明确缓解。