Autoimmune thyroiditis in a child: symptoms, causes, diagnosis, treatment, recovery and advice of an endocrinologist

Endocrinologists have not yet fully explored the causes of the development of autoimmune thyroiditis (AIT). By its origin, this pathology can be caused by heredity, and can be acquired throughout life.

If the occurrence occurred during pregnancy, the consequences of autoimmune thyroiditis for a child may be different. Most of all, it affects the inhibition of the intellectual development of the baby.

Causes

There is every reason to believe that a hereditary predisposition is still the primary cause of autoimmune thyroiditis in children.

But even if the child has a hereditary predisposition to AIT, then this does not mean that he will necessarily fall ill. In the second case, the starting point for the appearance of autoimmune thyroiditis of the thyroid gland in a child can be frequent acute respiratory infections and other chronic foci that provoke inflammation, in which an infection gets into the respiratory tract. In such cases, the body is greatly weakened and the functions of the immune system are impaired.

Weakened immunity due to stress ceases to distinguish between the cells of your own body and confuses them with foreign ones. Other stresses (psycho-emotional) can also provoke the pathology, as well as circumstances such as trauma to the thyroid gland, ecological disturbance , or too long living in an area with increased radiation. The relationship of endocrine disruption with the child’s gender and age has also been repeatedly observed. Among boys, the number of patients is much less than among girls.

Symptoms

Autoimmune thyroiditis in children is a disease characterized by a chronic course. It is expressed in the development of inflammation in the tissues of the thyroid gland in response to damage to its cells by the immune system. The follicles are attacked, resulting in their destruction.

The main symptoms of autoimmune thyroiditis in a child are:

• the occurrence of goiter;
• production of antibodies to thyroglobulin and thyroperoxidase;
• violation of the synthesis of peripheral thyroid-stimulating hormones.

The development of goiter is a gradual process. Initially, the child may feel pain in the thyroid gland, experience difficulty in swallowing and breathing. However, pain is usually mild. The child most often does not complain about anything, his hormonal background is normal.

The main symptom of thyroiditis is dry mouth, especially in the morning. It is characteristic that the child does not feel thirst at the same time. In children with autoimmune thyroiditis, there is a slight developmental delay from peers. After some time, the autoimmune goiter may disappear on its own. That is, recovery comes suddenly.

Perhaps this is due to the disappearance of provoking factors before the process of changes in the thyroid gland has become irreversible. But in some cases, such a goiter lasts a long time and as a result can lead to the development of hypothyroidism.

Kinds

The following is a classification and description of autoimmune thyroiditis by species. The functional activity of the thyroid gland in medicine distinguishes between euthyroid, hyperthyroid and hypothyroid thyroiditis.

Euthyroid goiter is the growth of the thyroid gland with its normal function. However, the thyroid gland in the patient is still enlarged. The reason in this case is a lack of thyroid hormones. The child's body in this way compensates for their lack. This is the most common variant of the disease. Every second case of goiter is euthyroid. Compared to toxic goiter, it is less dangerous. Euthyroid goiter is sometimes called "non-toxic", but such a definition is less preferred.

Hyperthyroid goiter is characterized by an increase in thyroid activity - hyperthyroidism. This is a short stage of the disease. It causes massive destruction of thyroid cells and the release of a large number of hormones into the blood.

Hypothyroid goiter is a disease caused by inhibition of all thyroid function. With autoimmune thyroiditis, it has a chronic, progressive character. In the course of the disease, latent and clinical types of autoimmune thyroiditis are distinguished. Latent proceeds secretly, without special clinical manifestations; clinical, on the contrary, is characterized by vivid symptoms.

According to the degree of change in the volume of the thyroid gland, hypertrophic and atrophic forms are distinguished. The first is characterized by proliferation of tissues and the formation of goiter. Atrophic is accompanied by atrophy (death) of thyroid tissue with a significant decrease in its size.

Diagnostics

The diagnosis of AIT for a child can be made by a pediatric endocrinologist. It is important to know the child's complaints:

• neck size has become larger;
• feeling of suffocation in the neck ;
• uneven breathing when the child is lying on his back;
• pain in the thyroid gland.

These symptoms indicate an increase in thyroid size.

And these signs indicate a lack or transient increase in the level of thyroid hormones:

• emotional breakdowns;
• decreased attention levels;
• weight loss;
• trembling hands.

It is important to know about the relatives of a child with a similar diagnosis. A visual examination by a doctor is not enough to diagnose AIT.

Diagnosis of such a disease requires:

1. Laboratory research.
2. General blood analysis.
3. Blood chemistry.
4. The levels of thyroid hormones (T3, T4) and thyroid stimulating hormone (TSH) are checked.
5. Detection of antibodies to thyroid tissue.
6. Instrumental examination: ultrasound of the thyroid gland.

A biopsy to exclude the diagnosis of malignant tumors in the thyroid gland is performed in the presence of nodules in the thyroid gland.

AIT is diagnosed when:

1. A blood test showed a high level of antibodies to the gland.
2. Confirmation was given by ultrasound data.
3. With clinical indicators of hypothyroidism.

Surgery

Surgery for autoimmune thyroiditis in a child may be required in the following cases:

1. Cancer is suspected.
2. The thyroid gland compresses the laryngeal nerve and treatment with Levothyroxine did not give the desired effect.
3. Found nodes in the thyroid gland.
4. Other methods of treatment did not have the desired effect.

In the above cases, a subtotal stumectomy is performed. After the operation, it is necessary to prescribe the thyroid hormones, since after surgery, hypothyroidism almost always develops. For this reason, cases of surgical intervention with autoimmune thyroiditis are extremely rare. Also, after performing the operation, lifelong replacement therapy can be prescribed.

If the thyroid gland is greatly enlarged and complicates the breathing and swallowing of the child, compresses the organs of the neck, then surgery is carried out immediately. Otherwise, the child is prescribed special medications, the action of which is aimed at normalizing the thyroid gland. The treatment of autoimmune thyroiditis is carried out under the mandatory control of the level of thyroid hormones and ultrasound.

Drug treatment

If an autoimmune thyroiditis was detected in a child, then the necessary amount of hormones is introduced into the child's body for treatment. The use of stronger drugs - such as glucocorticoids, is resorted to in the more complicated phases of the disease. If an increase in the functional work of the thyroid gland is noticed, then thyrostatics are used. Anti-inflammatory drugs are used to reduce antibody production. It is also advised to use vitamins and drugs to improve the functioning of the immune system.

Medication

When a disease is advised, such treatment of autoimmune thyroiditis in children:

1. "Tiamazole" - leads the thyroid gland to a stable state. Apply regularly for a month and a half. After this course, use the medicine in smaller doses (no more than 10 mg in the next two months).
2. "Merkazolil." Three tablets a day should be taken in 3 tablets (5 mg). It is advisable to take the medicine after eating, while consuming a large amount of water. With an allergy to the medicine, the child experiences nausea and bodily itching.
3. "Metindol". Doctors advise taking no more than two tablets per day. Do not use this medicine if the child has heart defects. The drug may cause a rash and nausea.
4. Voltaren. To correct the use, consultation with a doctor is necessary. Usually take one tablet no more than three times a day. For young children under the age of 6, this drug is not recommended.

Alternative treatment

One of the main methods of treating autoimmune thyroiditis in children and adolescents is immunomodulators (Euphorbia pallas, red brush). It is much more effective to take them together with anti-inflammatory herbs (sweet clover, elderberry). It is also necessary to use herbs that in every way improve blood flow, for example:

• red root;
• raspberries;
• pion;
• willow.

After each meal (preferably three times a day), you need to drink a glass of herbal tincture: Baikal skullcap, meadowsweet, immortelle sandy, adonis, field horsetail, common flax. Before going to bed, 25 drops of peony tincture should be taken along with 100 ml. water

Power Features

With this disease, you need to eat foods rich in fiber and various vitamins. It is necessary to eat as much cereal, various vegetables, cottage cheese, greens as possible, and one should not forget about meat. Products containing iodine are also needed in this diet. Autoimmune thyroiditis can also be treated with bear bile. During the treatment period, you can not expose yourself to heavy physical exertion and stress.

Recovery and advice of the endocrinologist

According to clinical recommendations, autoimmune thyroiditis in children requires a certain lifestyle:

1. Physical activity needs to be reduced. The disease is often accompanied by pain in the muscles or joints. Irregularities in the functioning of the heart may occur, the pressure changes regularly - it increases or decreases. In addition, the disease disrupts the metabolism, and this leads to an increase in injuries. It is necessary to consult a doctor about what loads are suitable for the body in this condition. And it's better to spend more time in the fresh air and walk on foot.
2. Do not abuse the sun. A long stay on the beach will not give anything good to a person with autoimmune thyroiditis.
3. As for traveling by sea, there are also restrictions. In the event that a person has excessive thyroid-stimulating hormone, it is not necessary to be in sea water for more than 10 minutes.
4. Stressful situations must be avoided - less worry and worry.

The prognosis for autoimmune thyroiditis in children is favorable. Of course, the disease cannot be completely eliminated, but with proper timely treatment, it will be possible to get rid of the consequences.