{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:46:38Z","timestamp":1784641598576,"version":"3.55.0"},"reference-count":16,"publisher":"Korean Society of Pediatric Endocrinology","issue":"5","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-apem.org"],"crossmark-restriction":true},"short-container-title":["Ann Pediatr Endocrinol Metab"],"published-print":{"date-parts":[[2024,10,31]]},"abstract":"<jats:p>Purpose: Few data on the clinical course after levothyroxine (L-T4) discontinuation in pediatric patients with Hashimoto thyroiditis (HT) are available. We investigated outcomes and predictors for successful withdrawal from L-T4 among children with HT.Methods: Among 168 patients diagnosed with HT between January 2000 and March 2021 at Seoul National University Children\u2019s Hospital and in whom L-T4 therapy was initiated during childhood, we attempted to discontinue this therapy in 47, 3 boys and 44 girls. L-T4 was restarted when patients developed overt or subclinical hypothyroidism (thyroid-stimulating hormone [TSH] levels\u226510 mIU\/L) after L-T4 discontinuation.Results: Median age at discontinuation was 15.4 years (12.7\u201318.4 years) with a median duration of L-T4 therapy of 47 months (20.3\u201380.3 months). During the median 30 months of follow-up (10.6\u201361.0 months) after L-T4 discontinuation, 33 (70.2%) developed thyroid dysfunction. Among these patients, 17 were eventually restarted on L-T4. TSH levels over 50 mIU\/L at L-T4 initiation (hazard ratio, HR 3.5, P=0.002), age under 12 years at L-T4 discontinuation (HR 11.1, P=0.0001), and TSH levels higher than the upper 50% of normal (above 2.25 mIU\/L in the present study) at L-T4 discontinuation (HR 2.7, P=0.014) were significantly predictive for overt hypothyroidism or subclinical hypothyroidism after L-T4 discontinuation. In addition, age under 12 years at L-T4 discontinuation was only predictive factor for restarting L-T4 medication (HR 4.3, P=0.012).Conclusion: L-T4 discontinuation in pediatric patients with HT resulted in thyroid dysfunction in 70.2% of cases; 36.2% of patients who attempted discontinuation required resumption of L-T4. Older age and lower TSH levels at L-T4 discontinuation were advantageous for successful withdrawal.<\/jats:p>","DOI":"10.6065\/apem.2346204.102","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T09:02:35Z","timestamp":1730278955000},"page":"337-343","update-policy":"https:\/\/doi.org\/10.6065\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors for thyroid dysfunction after discontinuation of levothyroxine in children and adolescents with Hashimoto thyroiditis"],"prefix":"10.6065","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7639-2010","authenticated-orcid":true,"given":"Min Jee","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2847-2643","authenticated-orcid":true,"given":"Yun Jeong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9396-1676","authenticated-orcid":true,"given":"Yunsoo","family":"Choe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-1134","authenticated-orcid":true,"given":"Choong Ho","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9179-1247","authenticated-orcid":true,"given":"Young Ah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4096","reference":[{"key":"ref1","volume-title":"","author":"Akamizu"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00565"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03501.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000343815"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000362597"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/1687-9856-2010-281453"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2017.32.1.124"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0235"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2013-0373"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1530\/ec-17-0023"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2020.0679"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233596"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)92567-2"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.007"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2018.61.5.135"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1530\/eje-20-0051"}],"container-title":["Annals of Pediatric Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-apem.org\/upload\/pdf\/apem-2346204-102.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-apem.org\/journal\/view.php?doi=10.6065\/apem.2346204.102","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-apem.org\/upload\/pdf\/apem-2346204-102.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T09:03:39Z","timestamp":1730279019000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-apem.org\/journal\/view.php?doi=10.6065\/apem.2346204.102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,31]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.6065\/apem.2346204.102","relation":{},"ISSN":["2287-1012","2287-1292"],"issn-type":[{"value":"2287-1012","type":"print"},{"value":"2287-1292","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,31]]},"assertion":[{"value":"2023-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}