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Growth in Autoimmune Thyroiditis: Clinical Features, Controversies, and Outcomes in the Pediatric Population

  • Susan Demartini
  • Mark D. DeBoer
Chapter

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.

Keywords

Obese Child Subclinical Hypothyroidism Adult Height Congenital Hypothyroidism Autoimmune Thyroiditis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of VirginiaCharlottesvilleUSA

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