Clinico-diagnostic characteristics of autoimmune thyroiditis in children

As many as 174 children (152 with autoimmune thyroiditis, 12 with thyroid diseases of non-autoimmune genesis and 10 with diffuse toxic goiter) underwent clinical and laboratory examinations with a purpose of delineating the clinical course and comparative assessments of the methods applied in the diagnosis of autoimmune thyroiditis. High risk for the disease in the pre- and pubertal age, the lack of a specific appearance, gradual disease development, uneventful course in many cases with a progressive development of hypothyrosis, and rare development of the grave patterns of hypothyrosis have been established. In clinically euthyroid conditions, the thyroliberin test revealed the predominance of latent or evident hypothyrosis in the majority of patients. Aspiration puncture of the thyroid accompanied by a cytological study of the punctate and detection of circulating immune complexes (increase of the content of medium-size circulating immune complexes) turned out to be of high diagnostic value. The measurement of the titer of antithyroid antibodies is of importance provided their level is high. Nevertheless the lack of antibodies does not allow one to exclude autoimmune thyroiditis. The scanning of the thyroid is of additional diagnostic significance, particularly in cases that require differentiation with nodular patterns of goiter and neoplasms.