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Hashimoto's Thyroiditis in Children

Pediatric Autoimmune Thyroiditis

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Hashimoto's Thyroiditis in Children?

Autoimmune chronic lymphocytic thyroiditis with progressive thyroid follicle destruction.

Most common cause of acquired hypothyroidism and goiter in children >6 years.

Female predominance (4:1 in adolescents).

Strong genetic component (HLA-DR3, DR4, DR5; CTLA-4 polymorphisms).

Symptoms

Goiter (firm, non-tender, lobulated thyroid).
Hypothyroid symptoms: fatigue, cold intolerance, weight gain, dry skin, constipation.
Bradycardia, slow growth, delayed puberty.
Cognitive slowing, declining school performance.
Hashitoxicosis: transient hyperthyroidism phase (rare in children).
Menstrual irregularities in adolescent girls.
Myxedema in untreated severe cases.

Risk Factors

Family history of autoimmune thyroid disease (positive in 40-60%).
Other autoimmune diseases: T1DM, celiac disease, vitiligo, alopecia areata.
Genetic syndromes: Down syndrome (30%), Turner syndrome (15-30%), Klinefelter, Noonan syndrome.
Iodine excess (rather than deficiency).
Selenium deficiency, vitamin D deficiency.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visible goiter or palpable thyroid enlargement.
  • Growth failure or weight gain in school-age child.
  • Fatigue, declining school performance.
  • Family history of thyroid autoimmunity.
  • Children with Down/Turner syndrome (annual screening recommended).

Treatment Methods

01
Diagnosis: TSH, free T4, anti-TPO and anti-Tg antibodies, thyroid ultrasound (heterogeneous echotexture).
02
Levothyroxine replacement: weight-based (4-6 µg/kg/day in young children, 2-4 µg/kg/day in adolescents).
03
Target TSH: lower half of reference range (1-2.5 mIU/L).
04
Initial follow-up every 3-6 weeks until stable, then every 6-12 months.
05
Euthyroid Hashimoto with positive antibodies: monitor TSH every 6-12 months (no treatment if euthyroid).
06
Subclinical hypothyroidism: treat if TSH >10 mIU/L, symptoms, growth failure.
07
Screen for associated conditions: T1DM, celiac (annually).
08
Adjust dose for growth, puberty; transition planning to adult endocrinology.

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.