A Case Report on A Rare Presentation of Hashimotos Thyroiditis in a Child

Hashimoto's thyroiditis [HT], first described by Hakaru Hashimoto in 1912, is the leading cause of hypothyroidism in children. It is an autoimmune disorder in which the thyroid gland is attacked by immune cells and antibodies, often presenting with vague symptoms. Early identification in pediatric patients is essential to prevent developmental and metabolic issues. HT is the main cause of acquired hypothyroidism and goitre in children and adolescents, particularly in iodine-deficient regions. This case report describes a 9-year-old boy diagnosed with HT, who exhibited unusual symptoms such as behavioural changes and subtle physical findings, despite having no significant medical history and normal developmental progress. Physical examination showed stable vital signs without acute distress. Diagnostic procedures, including fine needle aspiration cytology [FNAC] and neck ultrasound, confirmed HT with bilateral cervical lymphadenitis. Laboratory tests revealed low free thyroxine [FT4], elevated thyroid-stimulating hormone [TSH], and high antithyroid peroxidase [TPO] antibodies. The patient was treated with thyroxine replacement and medications for symptom relief, responding well to the treatment. This case underscores the importance of timely care, thorough diagnostic evaluation, and considering HT in children with non-specific symptoms. Keywords: Hashimoto’s thyroiditis [HT], Hypothyroidism, Paediatric autoimmune thyroid disease, Antithyroid antibodies, Levothyroxine