Home Investigation of autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents and evaluation of cardiac signs
Article
Licensed
Unlicensed Requires Authentication

Investigation of autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents and evaluation of cardiac signs

  • Veysel Nijat Baş EMAIL logo , Sebahat Yılmaz Agladioglu , Senem Özgür , Selmin Karademir and Zehra Aycan
Published/Copyright: May 29, 2015

Abstract

Objective: In the present study, it was aimed to investigate the concomitance of additional cardiac problems, mainly mitral valve prolapse, in adolescents and pediatric patients with Hashimoto’s thyroiditis, by screening autoimmune markers.

Materials and methods: Fifty-seven euthyroid patients, who applied to the Pediatric Endocrinology clinic at our institution with marked symptoms of hypothyroidism at the time of diagnosis, and were diagnosed and treated for Hashimoto’s thyroiditis, were included in the present study. All patients were evaluated by performing non-organ specific autoantibodies which could be tested at our institution, thyroid ultrasonography, two-dimensional echocardiography, and 24-h holter monitorization.

Results: Of the 57 cases with Hashimoto’s thyroiditis, 48 (84.2%) were female, and nine (15.8%) were male. In the echocardiographic evaluation, mitral valve problems were detected in 10 (17.5%) of all cases; mitral valve prolapse was diagnosed in eight (seven females and one male) cases, and mitral insufficiency was diagnosed in two female cases. First-degree atrioventricular block was observed in only two patients during 24-h holter monitorization. Different non-organ specific autoantibody positivity was distributed as antinuclear antibody in 15 (26.3%) cases, anticardiolipin IgG in two cases, anticardiolipin IgM in three cases, tissue transglutaminase IgA in one, glutamic acid decarboxylase in one, anti-insulin antibody in four cases, antiphospholipid IgG in one, and antiphospholipid IgM in one case.

Conclusion: It should be underlined that patients with Hashimoto’s thyroiditis should to be followed up closely for mitral valve prolapse and accompanying autoimmune diseases.


Corresponding author: Veysel Nijat Baş, MD, Clinics of Pediatric Endocrinology, Dr. Sami Ulus Research and Training Hospital of Women’s and Children’s Health and Diseases, Ankara, Turkey, Phone: +90-312-305-65-08, Fax: +90-312-317-03-53, E-mail:

Acknowledgments

We would like to thank the nurses and workers in our Clinics of Pediatric Endocrinology who helped us during this work.

Financial support: None.

Conflict of interest: None.

Ethical standards: The study was approved by the institutional ethics committee.

All of the authors have read and approved the paper and the manuscript has not been published previously nor it is under consideration by any other peer-reviewed journal.

References

1. Brown RS. Autoimmune thyroiditis in childhood. J Clin Res Pediatr Endocrinol 2013;5(Suppl. 1):45–9.Search in Google Scholar

2. de Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child 2009;94:33–7.10.1136/adc.2007.134841Search in Google Scholar PubMed

3. Özen S, Berk Ö, Şimşek DG, Darcan S. Clinical course of Hashimoto’s thyroiditis and effects of levothyroxine therapy on the clinical course of the disease in children and adolescents. J Clin Res Pediatr Endocrinol 2011;3:192–7.10.4274/jcrpe.425Search in Google Scholar PubMed PubMed Central

4. Park MK. Pediatric cardiology for practitioners, 5th ed. Philadelphia: Mosby, 2008:398–401.Search in Google Scholar

5. Grau JB, Pireli L, Yu P-J, Galloway AC, Ostrer H. The genetics of mitral valve prolapse. Clin Genet 2007;72:288–95.10.1111/j.1399-0004.2007.00865.xSearch in Google Scholar PubMed

6. Hepner AD, Kashani MA, Movahed MR. The prevalance of mitral valve prolapse in patients undergoing echocardiography for clinical reason. Int J Cardiol 2007;123:55–7.10.1016/j.ijcard.2006.11.130Search in Google Scholar PubMed

7. Evangelopoulou ME, Alevizaki M, Toumanidis S, Piperingos G, Mavrikakis M, et al. Mitral valve prolapse in autoimmune thyroid disease: an index of systemic autoimmunity? Thyroid 1999;9:973–7.10.1089/thy.1999.9.973Search in Google Scholar PubMed

8. Evangelopoulos ME, Toumanidis S, Sotou D, Evangelopoulos C, Mavrikakis M, et al. Mitral valve prolapse in young healthy individuals. An early index of autoimmunity? Lupus 2009;18: 436–40.Search in Google Scholar

9. Taş F, Bulut S, Eğilmez H, Oztoprak I, Ergür AT, et al. Normal thyroid volume by ultrasonography in healthy children. Ann Trop Paediatr 2002;22:375–9.10.1179/027249302125002047Search in Google Scholar PubMed

10. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of American College of Cardiology; American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 2006;48:11–2.10.1016/j.jacc.2006.05.021Search in Google Scholar PubMed

11. Babaoğlu K, Karaçayır N, Binnetoğlu K. Mitral valve prolapse in children: clinical characteristics of 113 patients. Turk Arch Ped 2009;44:57–61.Search in Google Scholar

12. Van Der Ham DP, De Vries JK, Van Der Merwe PL. Mitral valve prolapse: a study of 45 children. Cardiovasc J S Afr 2003;14:191–4.Search in Google Scholar

13. Boudoulas H. Mitral valve prolapse: etiology, clinical presentation and neuroendocrine function. J Heart Valve Dis 1992;1: 175–88.Search in Google Scholar

14. Tektonidou MG, Anapliotou M, Vlachoyiannopoulos P, Moutsopoulos HM. Presence of systemic autoimmune disorders in patients with autoimmune thyroid diseases. Ann Rheum Dis 2004;63:1159–61.10.1136/ard.2004.022624Search in Google Scholar PubMed PubMed Central

15. Blumberg D, Rutkowski M, Sklar C, Reggiardo D, Friedman D, et al. Juvenile autoimmune thyroiditis and mitral valve prolapse. Pediatr Cardiol 1992;13:89–91.10.1007/BF00798211Search in Google Scholar PubMed

16. Boelaert K, Newby PR, Simmonds MJ, Holder RL, Carr-Smith JD, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med 2010;123:183. e1–9.10.1016/j.amjmed.2009.06.030Search in Google Scholar PubMed

17. Kahaly G, Mohr-Kahaly S, Beyer J, Meyer J. Prevalence of myxomatous mitral valve prolapse in patients with lymphocytic thyroiditis. Am J Cardiol 1995;76:1309–10.10.1016/S0002-9149(99)80363-4Search in Google Scholar

18. Peene I, Meheus L, Veys EM, De Keyser F. Detection and identification of antinuclear antibodies (ANA) in a large and consecutive cohort of serum samples referred for ANA testing. Ann Rheum Dis 2001;60:1131–6.10.1136/ard.60.12.1131Search in Google Scholar

19. Scofield RH. Autoantibodies as predictors of disease. Lancet 2004;363:1544–6.10.1016/S0140-6736(04)16154-0Search in Google Scholar

20. Gordon T, Isenberg D. Organ specific and multisystemic autoimmune disease: part of a spectrum which may coexist in the same patient. Clin Rheumatol 1990;9:401–3.10.1007/BF02114404Search in Google Scholar PubMed

21. Vila P, Hernandez MC, Lopez-Fernandez MF, Battle J. Prevalence, follow-up and clinical significance of the anticardiolipin antibodies in normal subjects. Thromb Haemost 1994;72:209–13.10.1055/s-0038-1648840Search in Google Scholar

Received: 2014-9-1
Accepted: 2015-4-10
Published Online: 2015-5-29
Published in Print: 2015-7-1

©2015 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Thyroid
  3. Thyroid disorders revisited
  4. Genetic analysis of the paired box transcription factor (PAX8) gene in a cohort of Polish patients with primary congenital hypothyroidism and dysgenetic thyroid glands
  5. Prognostic factors in pediatric differentiated thyroid cancer patients with pulmonary metastases
  6. Reclassification of cytologically atypical thyroid nodules based on radiologic features in pediatric patients
  7. Evaluation of inflammatory and oxidative biomarkers in children with well-controlled congenital hypothyroidism
  8. Investigation of autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents and evaluation of cardiac signs
  9. Neonatal thyroid storm accompanied with severe anaemia
  10. Functional characterization of the novel sequence variant p.S304R in the hinge region of TSHR in a congenital hypothyroidism patients and analogy with other formerly known mutations of this gene portion
  11. Subclinical hypothyroidism as a rare cofactor in chronic kidney disease (CKD) – related anemia
  12. Cytometric analysis of perforin expression in NK cells, CD8+, and CD4+ lymphocytes in children with autoimmune Hashimoto’s thyroiditis – a preliminary study
  13. Papillary thyroid cancer and autoimmune polyglandular syndrome
  14. Review article
  15. Should radioiodine be the first-line treatment for paediatric Graves’ disease?
  16. Image in pediatric endrocrinology
  17. Diffusion-weighted magnetic resonance imaging in a case of severe classic maple syrup urine disease
  18. Original articles
  19. Novel mutations of DAX1 (NR0B1) in two Chinese families with X-linked adrenal hypoplasia congenita and hypogonadotropic hypogonadism
  20. Rickets and vitamin D deficiency in Alaska native children
  21. Persistent elevation of fibroblast growth factor 23 concentrations in healthy appropriate-for-gestational-age preterm infants
  22. Parents’ experiences of having a baby with ambiguous genitalia
  23. Effect of GnRHa 3.75 mg subcutaneously every 6 weeks on adult height in girls with idiopathic central precocious puberty
  24. Congenital adrenal hyperplasia in children – a survey on the current practice in the UK
  25. Randomized clinical trial evaluating metformin versus oral contraceptive pills in the treatment of adolescents with polycystic ovarian syndrome
  26. Influence of the body weight on the onset and progression of puberty in boys
  27. Therapy monitoring in congenital adrenal hyperplasia by dried blood samples
  28. Hyperinsulinemic hypoglycemia: think of hyperinsulinism/hyperammonemia (HI/HA) syndrome caused by mutations in the GLUD1 gene
  29. Sulfonylurea in the treatment of neonatal diabetes mellitus children with heterogeneous genetic backgrounds
  30. Monitoring gonadotropin-releasing hormone analogue (GnRHa) treatment in girls with central precocious puberty: a comparison of four methods
  31. Dietary intake, body composition, and physical activity among young patients with type 1 diabetes mellitus
  32. Metabolic syndrome in obese children and adolescents in Serbia: prevalence and risk factors
  33. Progressive osseous heteroplasia, as an isolated entity or overlapping with Albright hereditary osteodystrophy
  34. Patient reports
  35. 17α-Hydroylase/17,20-lyase deficiency related to P.Y27*(c.81C>A) mutation in CYP17A1 gene
  36. A patient developing anaphylaxis and sensitivity to two different GnRH analogues and a review of literature
  37. Idiopathic short stature due to novel heterozygous mutation of the aggrecan gene
  38. Triple A syndrome with a novel indel mutation in the AAAS gene and delayed puberty
  39. Case report: long-term follow-up of a 45,X male with SHOX haploinsufficiency
  40. Antenatal Bartter syndrome presenting as hyperparathyroidism with hypercalcemia and hypercalciuria: a case report and review
  41. Successful use of continuous subcutaneous hydrocortisone infusion after bilateral adrenalectomy secondary to bilateral pheochromocytoma
  42. Donohue syndrome: a new case with a new complication
  43. Euprolactinemic galactorrhea secondary to domperidone treatment
  44. 17βHSD-3 enzyme deficiency due to novel mutations in the HSD17B3 gene diagnosed in a neonate
  45. Two different patterns of mini-puberty in two 46,XY newborns with 17β-hydroxysteroid dehydrogenase type 3 deficiency
  46. Short communication
  47. Early onset hearing loss in autosomal recessive hypophosphatemic rickets caused by loss of function mutation in ENPP1
Downloaded on 8.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2014-0373/html
Scroll to top button