ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Predictive factors for hypothyroidism in childhood autoimmune thyroiditis: insights from long-term follow-up
Laura Astara 1 , Laura Pinna 1 , Giulia Faa 1 , Alessandro Colleo 1 , Francesco David 1 , Sandro Loche 1 , Angelico Lampis 1 , Stefano Mariotti 1 , Francesco Boi 1 & Giulia Lanzolla 1
1University of Cagliari, Cagliari, Italy
JOINT2904
Introduction: Predictive factors for hypothyroidism progression in children with autoimmune thyroiditis (AIT) remain unclear.
Objectives: To characterize the clinical presentation of AIT, assess long-term outcomes, and identify predictive factors for disease progression.
Methods: Data from 127 consecutive patients under 18 years of age at presentation were analyzed (mean follow-up:7.1 years; range:0–20yr).
Results: At presentation, 57% of patients were euthyroid, 28% had subclinical hypothyroidism, and 15% had overt hypothyroidism. By the end of follow-up, among euthyroid children, 20.5% developed overt hypothyroidism, and 6.8% progressed to subclinical hypothyroidism. The subclinical hypothyroidism group showed dynamic changes: 45.7% of patients progressed to overt hypothyroidism, while 37.1% reverted to euthyroidism. Finally, the overt hypothyroidism group did not show significant changes. Patients progressing to hypothyroidism were younger at diagnosis (P = 0.0008) with higher thyroid peroxidase antibodies (AbTPO) titers (P < 0.0001), higher TSH (P < 0.0001) and lower FT4 levels (P = 0.0026). Thyroid volume >6mL increased hypothyroidism risk (P = 0.0060, OR:0.347,95%CI:0.15-0.75). Multivariate analysis confirmed that AbTPO titers influence TSH levels at follow-up (P < 0.0001). Cutoff thresholds were established to refine predictive accuracy. Patients diagnosed under 10 years of age (P = 0.043, OR:0.458,95%CI:0.22-0.96), with AbTPO>92 IU/mL (P < 0.0001, OR:25,95%CI:8.78-63.11), and TSH>4.95 μIU/mL (P < 0.0001, OR:15.43,95%CI:5.61-37.57) had highest risk of developing hypothyroidism. Notably, AbTPO>92 IU/mL and TSH>4.95 μIU/mL demonstrated the strongest predictive power. AbTPO titers had a positive predictive value (PPV) and negative predictive value (NPV) of 83%, while TSH >4.95 yielded a PPV of 79% and an NPV of 80%.
Conclusions: Twenty percent of euthyroid children developed hypothyroidism, compared to 45.7% of those with subclinical hypothyroidism. TSH>4.95 μIU/mL and AbTPO titers had the greatest predictive power. Patients diagnosed under 10 years of age had a higher risk of developing hypothyroidism, suggesting that prolonged exposure to autoimmunity may play a role. Further studies are needed to validate predictive models for hypothyroidism development in children with AIT.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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