Abstract
Autoimmune thyroid disease is the most common autoimmune condition, affecting approximately 2% of the female population and 0.2% of the male population (1). Its overall prevalence peaks in adulthood, but it is also the most common etiology of acquired thyroid dysfunction in pediatrics (2,3). This chapter presents a summary of autoimmune thyroid disease, discussing first chronic autoimmune thyroiditis and then Graves’ disease, with an emphasis on their clinical management. Optimal quantities of thyroid hormone are critical to neurodevelopment and growth. By maintaining an appropriate index of suspicion, the clinician can often recognize thyroid dysfunction in its early stages.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Saravanan P, Dayan CM. Thyroid autoantibodies. Endocrinol Metab Clin North Am 2001; 30 (2): 315–337.
Hunter I, Greene SA, MacDonald TM, et al. Prevalence and aetiology of hypothyroidism in the young. Arch Dis Child 2000; 83 (3): 207–210.
Segni M, Leonardi E, Mazzoncini B, et al. Special features of Graves’ disease in early childhood. Thyroid 1999; 9 (9): 871–817.
Lafranchi S. Thyroiditis and acquired hypothyroidism. Pediatr Ann 1992;21(1): 29, 32–39.
Foley TP Jr, Abbassi V, Copeland KC, et al. Brief report: hypothyroidism caused by chronic autoimmune thyroiditis in very young infants. N Engl J Med 1994; 330 (7): 466–468.
Ostergaard GZ, Jacobsen BB. Atrophic, autoimmune thyroiditis in infancy. A case report. Horm Res 1989; 31 (4): 190–192.
Davies TF, Amino N. A new classification for human autoimmune thyroid disease. Thyroid 1993; 3 (4): 331–333.
Larsen PR, Davies TF, Hay ID. The Thhyroid Gland. In: Williams Textbook of Endocrinology, 9th ed. Wilson JD, Foster DW, Kronenberg HM, Larsen PR, eds. W.B. Saunders Company, Philadelphia, 1998, pp. 389–515.
Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med 1996; 335 (2): 99–107.
Matsuura N, Konishi J, Yuri K, et al. Comparison of atrophic and goitrous auto-immune thyroiditis in children: clinical, laboratory and TSH-receptor antibody studies. Eur J Pediatr 1990; 149 (8): 529–533.
Takasu N, Yamada T, Takasu M, et al. Disappearance of thyrotropin-blocking antibodies and spontaneous recovery from hypothyroidism in autoimmune thyroiditis. N Engl J Med 1992; 326 (8): 513–518.
Foley TP. Disorders of the Thyroid in Childern. In: Pediattric Endocrinology, Sperling MA, ed. W.B. Saunders Company, Philadelphia, 1996, pp. 171–194.
Chiesa A, Gruniero de Papendieck L, Keselman A, et al. Final height in long-term primary hypothyroid children. J Pediatr Endocrinol Metab, 1998; 11 (1): 51–58.
Boersma B, Otten BJ, Stoelinga GB, et al. Catch-up growth after prolonged hypothyroidism. Eur J Pediatr 1996; 155 (5): 362–367.
Castro-Magana M, Angulo M, Canas A, et al. Hypothalamic-pituitary gonadal axis in boys with primary hypothyroidism and macroorchidism. J Pediatr 1988; 112 (3): 397–402.
Jannini EA, Ulisse S, D’Armiento M. Macroorchidism in juvenile hypothyroidism. J Clin Endocrinol Metab 1995; 80 (8): 2543–2544.
Anasti, JN, Flack MR, Froehlich J, et al. A potential novel mechanism for precocious puberty in juvenile hypothyroidism. J Clin Endocrinol Metab 1995; 80 (1): 276–279.
Lum SM, Nicoloff JT, Spencer CA, et al. Peripheral tissue mechanism for maintenance of serum triiodothyronine values in a thyroxine-deficient state in man. J Clin Invest 1984; 73 (2): 570–575.
Bianco AC, Salvatore D, Gereben B, et al. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocr Rev 2002; 23 (1): 38–89.
Nordyke RA, Gilbert FI, Jr., Miyamoto LA, et al. The superiority of antimicrosomal over antithyroglobulin antibodies for detecting Hashimoto’s thyroiditis. Arch Intern Med 1993; 153 (7): 862–865.
Foley TP Jr. Mediators of thyroid diseases in children. J Pediatr, 1998; 132 (4): 569–570.
Hancock SL, McDougall IR, Constine LS, Thyroid abnormalities after therapeutic external radiation. Int J Radiat Oncol Biol Phys, 1995. 31 (5): p. 1165–70.
Huang SA, Fish DA, Dorfman DM, Salvatore D, Kozakewich HP, Mandel SJ, Larsen PR. A 21 year Old Woman with Consumptive Hypothyroidism due to a Vascular Tumor Expressing Type 3 Iodothyronine Deiodinase. Journal of Clinical Endocrinology Metabolism, 2002; 87 (10): 4457–4461.
Huang SA, Tu HM, Harney JW, et al. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. New England Journal of Medicine 2000; 343 (3): 185–189.
Ayling RM, Davenport M, Hadzic N, et al. Hepatic hemangioendothelioma associated with production of humoral thyrotropin-like factor. Journal of Pediatrics 2001; 138 (6): 932–935.
Mandel SJ, Brent GA, Larsen PR. Levothyroxine therapy in patients with thyroid disease. Ann Intern Med 1993; 119 (6): 492–502.
Van Dop C, Conte FA, Kock TK, et al. Pseudotumor cerebri associated with initiation of levothyroxine therapy for juvenile hypothyroidism. N Engl J Med 1983; 308 (18): 1076–1080.
Slyper AH, Swenerton P. Experience with low-dose replacement therapy in the initial management of severe pediatric acquired primary hypothyroidism. J Pediatr Endocrinol Metab 1998; 11 (4): 543–547.
Sklar CA, Qazi R, David R. Juvenile autoimmune thyroiditis. Hormonal status at presentation and after long-term follow-up. Am J Dis Child 1986; 140 (9): 877–880.
Maenpaa J, Raatikka M, Rasanen J, et al. Natural course of juvenile autoimmune thyroiditis. J Pediatr 1985; 107 (6): 898–904.
Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999; 341 (8): 549–555.
Weetman AP. Graves’ disease. N Engl J Med 2000; 343 (17): 1236–1248.
Zimmerman D, Lteif AN. Thyrotoxicosis in children. Endocrinol Metab Clin North Am 1998 27 (1): 109–126.
Lavard L, Ranlov I, Perrild H, et al. Incidence of juvenile thyrotoxicosis in Denmark, 1982–1988. A nationwide study. Eur J Endocrinol 1994; 130 (6): 565–568.
Gruters A. Ocular manifestations in children and adolescents with thyrotoxicosis. Exp Clin Endocrinol Diabetes 1999;107:172-S 174.
Buckler JM, Willgerodt H, Keller E. Growth in thyrotoxicosis. Arch Dis Child 1986; 61 (5): 464–471.
Wong GW, Lai J, Cheng PS. Growth in childhood thyrotoxicosis. Eur J Pediatr 1999; 158 (10): 776–779.
Deroot LJ, Larsen PR, Henneman G. Acute and Subacute Thyroiditis. In: The Thyroif and Its Diseases, 6th ed. DeGroot LJ, Larsen PR, Henneman G. eds. Churchill Livingstone, New York, pp. 697–709.
Marqusee, E., S.T. Haden, and R.D. Utiger, Subclinical thyrotoxicosis. Endocrinol Metab Clin North Am 1998; 27 (1): 37–49.
Koutras DA. Subclinical hyperthyroidism. Thyroid 1999; 9 (3): 311–315.
Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994; 331 (19); 1249–1252.
Utiger RD. Subclinical hyperthyroidismjust a low serum thyrotropin concentration, or something more? N Engl J Med 1994; 331 (19): 1302–1303.
Franklyn JA. The management of hyperthyroidism. N Engl J Med 1994, 330 (24): 1731–1738.
Klein I, Becker DV, Levey GS. Treatment of hyperthyroid disease. Ann Intern Med 1994, 121 (4): 281–288.
Hashizume K, Ichikawa K, Sakurai A, et al. Administration of thyroxine in treated Graves’ disease. Effects on the level of antibodies to thyroid-stimulating hormone receptors and on the risk of recurrence of hyperthyroidism. N Engl J Med 1991; 324 (14): 947–953.
McIver B, Rae P, Beckett G, et al. Lack of effect of thyroxine in patients with Graves’ hyperthyroidism who are treated with an antithyroid drug. N Engl J Med 1996; 334 (4): 220–224.
Lucas A, Salinas I, Rius F, et al. Medical therapy of Graves’ disease: does thyroxine prevent recurrence of hyperthyroidism? J Clin Endocrinol Metab 1997; 82 (8): 2410–2413.
Rivkees SA, Sklar C, Freemark M. Clinical review 99: The management of Graves’ disease in children, with special emphasis on radioiodine treatment. J Clin Endocrinol Metab 1998; 83 (11): 3767–3776.
Lazar L, Kalter-Leibovici O, Pertzelan A, et al. Thyrotoxicosis in prepubertal children compared with pubertal and postpubertal patients. J Clin Endocrinol Metab 2000; 85 (10): 3678–3682.
Cooper DS, Goldminz D, Levin AA, et al. Agranulocytosis associated with antithyroid drugs. Effects of patient age and drug dose. Ann Intern Med 1983; 98 (1): 26–29.
LaFranchi, Hanna CE. Graves Disease in the Neonatal Period and Childhood. In: Werner Ingbar’s The Thyroid. A Fundamental and Clinical Text, Braverman LE, Utiger RD, eds. Lipppincott Williams Wilkins, Philadelphia, 2000, pp. 989–997.
Shulman DI, Muhar I, Jorgensen EV, et al. Autoimmune hyperthyroidism in prepubertal children and adolescents: comparison of clinical and biochemical features at diagnosis and responses to medical therapy. Thyroid 1997; 7 (5): 755–760.
Raza J, Hindmarsh PC, Brook CG. Thyrotoxicosis in children: thirty years’ experience. Acta Paediatr 1999; 88 (9): 937–941.
Ward L, Huot C, Lambert R, et al. Outcome of pediatric Graves’ disease after treatment with antithyroid medication and radioiodine. Clin Invest Med 1999; 22 (4): 132–139.
Moll GW Jr, Patel BR. Pediatric Graves’ disease: therapeutic options and experience with radioiodine at the University of Mississippi Medical Center. South Med J 1997; 90 (10): 1017–1022.
Clark JD, Gelfand MJ, Elgazzar AH. Iodine-131 therapy of hyperthyroidism in pediatric patients. J Nucl Med 1995; 36 (3): 442–445.
Safa AM, Schumacher OP, Rodriguez-Antunez A. Long-term follow-up results in children and adolescents treated with radioactive iodine (131I) for hyperthyroidism. N Engl J Med 1975; 292 (4): 167–171.
Foley TP Jr, Charron M. Radioiodine treatment of juvenile Graves disease. Exp Clin Endocrinol Diabetes 1997; 105: 61–65.
Cheetham TD, Wraight P, Hughes IA, et al. Radioiodine treatment of Graves’ disease in young people. Horm Res 1998; 49 (6): 258–262.
Refetoff S, Harrison J, Karanfilski BT, et al. Continuing occurrence of thyroid carcinoma after irradiation to the neck in infancy and childhood. N Engl J Med 1975; 292 (4): 171–175.
Baverstock K, Egloff B, Pinchera A, et al. Thyroid cancer after Chernobyl. Nature 1992; 359 (6390): 21–22.
Nikiforov Y, Gnepp DR, J.A. Fagin, Thyroid lesions in children and adolescents after the Chernobyl disaster: implications for the study of radiation tumorigenesis. J Clin Endocrinol Metab, 1996, 81 (1): p. 9–14.
Alexander EK, Larsen PR. High dose of (131)I therapy for the treatment of hyperthyroidism caused by Graves’ disease. J Clin Endocrinol Metab 2002; 87 (3): 1073–1077.
Bartalena L, Marcocci C, Bogazzi F, et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy. N Engl J Med 1998; 338 (2): 73–78.
Soreide JA, van Heerden JA, Lo CY, et al. Surgical treatment of Graves’ disease in patients younger than 18 years. World J Surg 1996; 20 (7): 794–799.
Sosa JA, Bowman M, Tielsch JM, et al. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 1998; 228 (3): 320–330.
Waldhausen JH. Controversies related to the medical and surgical management of hyperthyroidism in children. Semin Pediatr Surg 1997; 6 (3): 121–127.
Laurberg P, Nygaard B, Gilnoer D, et al. Guidelines for TSH-receptor antibody measurements in pregnancy: results of an evidence-based symposium organized by the European Thyroid Association. Eur J Endocrinol 1998; 139 (6): 584–586.
McKenzie JM, Zakarija M. Fetal and neonatal hyperthyroidism and hypothyroidism due to maternal TSH receptor antibodies. Thyroid 1992; 2 (2): 155–159.
Zakarija M, McKenzie JM. Pregnancy-associated changes in the thyroid-stimulating antibody of Graves’ disease and the relationship to neonatal hyperthyroidism. J Clin Endocrinol Metab 1983; 57 (5): 1036–1040.
Zimmerman D. Fetal and neonatal hyperthyroidism. Thyroid 1999; 9 (7): 727–733.
Mandel SH, Hanna CE, LaFranchi SH. Diminished thyroid-stimulating hormone secretion associated with neonatal thyrotoxicosis. J Pediatr 1986; 109 (4): 662–665.
Hashimoto H, Maruyama H, Koshida R, et al. Central hypothyroidism resulting from pituitary suppression and peripheral thyrotoxicosis in a premature infant born to a mother with Graves disease. J Pediatr 1995; 127 (5): 809–811.
Mandel S, Hanna C, LaFranchi S. Thyroid function of infants born to mothers with Graves disease. J Pediatr 1990; 117: 169–170.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Huang, S.A., Larsen, P.R. (2003). Autoimmune Thyroid Disease. In: Radovick, S., MacGillivray, M.H. (eds) Pediatric Endocrinology. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-336-1_17
Download citation
DOI: https://doi.org/10.1007/978-1-59259-336-1_17
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-61737-268-1
Online ISBN: 978-1-59259-336-1
eBook Packages: Springer Book Archive