Hashimoto's thyroiditis (HT) is one of the most common autoimmune endocrine diseases seen in the pediatric age group. It is considered a typical organ-specific disease characterized by autoimmune-mediated destruction of the thyroid gland. Thyroid autoantibodies (antithyroid Abs) in HT are not a causative agent but an indicator of gland damage. Anti-thyroglobulin antibodies (TG-Abs) and anti-thyroid peroxidase antibodies (TPO-Abs) have high sensitivity in the diagnosis of the disease. However, the specificity of TPO-Abs in particular is low. Graves’ disease (GD) is an autoimmune disease. Thyroid-stimulating hormone (TSH) receptor antibodies (TRAb) increase the production and secretion of thyroid hormone by stimulating the TSH receptor and cause diffuse toxic goiter formation.

Clinical findings (i.e., thyrotoxicosis symptoms including tachycardia, diffuse goiter, and prominent ocular symptoms), laboratory findings (i.e., high free thyroxine [FT4] and/or free triiodothyronine [FT3] levels, suppressed TSH, positive TRAb), and thyroid blood flow measured using pulse Doppler ultrasound (US) is widely used for diagnostic purposes. Differentiating GD from HT can sometimes be difficult based on clinical and laboratory findings. It has been reported that HT history can be detected before the onset of hyperthyroidism in at least 3–4% of children with GD, which may cause confusion between HT and GD.

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Mishita
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Journal of  Autoimmune Disorders