Abstract
Chronic lymphocytic thyroiditis (CLT) is an autoimmune process that is the most common cause of acquired hypothyroidism and can lead to severe growth failure. CLT is a frequent hormone abnormality in pediatrics, being present in up to 2.5% of children. Growth failure from severely low levels of thyroid hormone usually occurs as a late finding, because the onset of symptoms is often insidious. Hypothyroidism from CLT is associated with delayed bone age, and early diagnosis and treatment should preserve final height. Nevertheless, initial treatment with a full replacement dose of levothyroxine has been associated with rapid advancement of the bone age and a compromise in final adult height. Additionally, treatment of CLT with severe bone age delay during puberty may result in a decreased final height. Because of the relatively high incidence of the condition and the non-specific nature of many of the symptoms, physicians caring for children are encouraged to keep a low threshold for checking thyroid function in children. Though data are few, early discovery and treatment of the disease is felt to avoid significant growth effects.
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Abbreviations
- AMP:
-
Adenosine monophosphate
- BA:
-
Bone age
- BMI:
-
Body mass index
- CLT:
-
Chronic lymphocytic thyroiditis
- FSH:
-
Follicle-stimulating hormone
- hCG:
-
Human chorionic gonadotropin
- HA:
-
Height age
- HLA:
-
Human leukocyte antigen
- SCH:
-
Subclinical hypothyroidism
- SDS:
-
Standard deviation score
- TRH:
-
Thyrotropin-releasing hormone
- TSBAb:
-
TSH receptor blocking antibody
- TSH:
-
Thyroid-stimulating hormone
- TSI:
-
Thyroid-stimulating immunoglobulin
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Demartini, S., DeBoer, M.D. (2012). Growth in Autoimmune Thyroiditis: Clinical Features, Controversies, and Outcomes in the Pediatric Population. In: Preedy, V. (eds) Handbook of Growth and Growth Monitoring in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1795-9_158
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