Source: Jurnalul Pediatrului. Although AT and GD have different phenotypes, they are believed to share doenca de oxiurose tratamento etiological factors.
AT recognizes a goitrous form Hashimoto's thyroiditis - HT and an atrophic one. The clinical picture of the hypertrophic form comprises a diffuse goiter with heterogeneous functionality. The clinical peculiarities of acquired hypothyroidism in childhood are represented by growth failure and retardation of bone age, which equals or exceeds the retardation in linear growth.
The form of AT are represented by: euthyroid goiter, subclinical hypothyroidism and goiter, primary thyroid failure, adolescent goiter, painless silent thyroiditis, postpartum thyroiditis, alternating hypo- and hyperthyroidism, and iatrogenic AT.
Associated diseases are represented by: autoimmune polyglandular syndromes types 1 and 2diabetes mellitus type 1 and many other immunopathies.
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Unusual associated syndromes, rarely observed in adulthood are represented by: Hashimoto's encephalopathy, Hashimoto's papillary thyroid cancer remission and thyroid associated ophthalmopathy TAO. The link between HT and thyroid carcinoma remains obscure, but cases with HT are considered to be at higher risk for papillary carcinoma, compared with those without HT.
The natural history of AT is not fully understood. Euthyroid patients and those with subclinical hypothyroidism show a trend towards progressively deteriorating thyroid function. Predictive factors for hypothyroidism are: goiter, elevated thyroglobulin antibodies at presentationand progressive increase in TSH and both antithyroid antibodies. Graves' disease is a form of autoimmune hyperthyroidism associated with ocular papillary thyroid cancer remission TAO.
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Pretibial myxedema and acropachy are extremely rare associations in adults. GD is by far the most common etiology of hyperthyroidism in childhood.
The onset of symptoms may be insidious. Most of children present with decreased concentration and poor scholar performance, hyperactivity and behavioral disturbances.
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Unlike adults, the majority of children with GD are treated with antithyroid drugs. The predictors of remission are represented by: age, the severity of thyrotoxicosis, the level of TSH receptor antibodies, and the initial therapeutic response.
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In adults, TAO represents a major diagnostic and therapeutic aspect. AITD associated with pregnancy imposes a careful monitoring and treatment. English Copyright of Jurnalul Pediatrului is the property of Romanian Society of Pediatric Surgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission.
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