Natural Course of Autoimmune Thyroid Disease in DiabeticChildren

Overview

Background.
Autoimmune thyroid disease (AITD) represents the most frequent associated manifestation of theautoimmune disease in children with Type 1 diabetes mellitus (T1DM). The aim of the study was to evaluate theprevalence and natural course of AITD in unselected cohort of diabetic children.Methods and Results. TSH, free thyroxin, thyreoglobulin autoantibodies (Ab-hTG), peroxidase autoantibodies(Ab-TPO) and thyroid sonography were prospectively evaluated (1 to 6 years; 323 patient-years) in 110 patientswith T1DM (age 2.1–20.8 years; 60 boys). Mild elevation of Ab-hTG and/or Ab-TPO levels (>100, 1000 mIU/l) was found in 12 patients (11 %;boys:girls 1:1). Out of these, eight had increased thyroid volume and ten had abnormal echotexture. Subclinicalhypothyroidism developed within the observation period in nine of them (boys:girls 2:1).Conclusions.AITDwas found in 31 (28%) children and adolescents with T1DM.Whereasmild elevation of Ab-hTGand/or Ab-TPO levels was not accompanied withmorphological changes of the thyroid and did not predict functionaldisorder, severely elevated levels were associated with the early risk of subclinical hypothyroidism.

Key words:
type 1 diabetes mellitus, autoimmune thyroid disease, subclinical hypothyroidism, thyroid autoantibodies,children.