Differential presentation for children with autoimmune thyroiditis discovered because of symptom development or screening

Aim: To determine clinical and laboratory differences at presentation of autoimmune thyroiditis (AIT) among children with AIT discovered due to symptom development and those discovered by screening due to having increased risk of AIT from an underlying disorder. Study design: Retrospective chart review of patients with AIT seen in an academic pediatric endocrinology practice. We identified 252 children with AIT: 160 diagnosed following symptom development (the 'symptoms' group), 74 with AIT found by screening (the 'screening' group) and 18 with increased risk who were tested because they developed symptoms (the 'symptoms + screening' group). Results: We found that compared to the 'symptoms' group, individuals in the 'screening' group were younger and had a lower proportion of females. In addition, the 'screening' group were more likely to be euthyroid (60% of 4screening' vs 19% for 'symptoms') and less likely to have overt hypothyroidism (7% 'screening' vs 45% 'symptoms'). The 'screening' group were also less likely to have multiple symptoms of hypothyroidism noted in retrospect. Conclusions: Screening for AIT identifies patients at an earlier stage of AIT. Additionally, the association of symptoms with subclinical hypothyroidism may lend support to initiating levothyroxine treatment for symptomatic children with mild TSH elevations.