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REVIEW article

Front. Endocrinol.

Sec. Pediatric Endocrinology

Unveiling the hidden: acquired pediatric hypothyroidism

Provisionally accepted
Mariacarolina SalernoMariacarolina Salerno1*Donatella CapalboDonatella Capalbo2*Mariella ValenziseMariella Valenzise3Raffaella Di MaseRaffaella Di Mase4Letteria Anna MorabitoLetteria Anna Morabito5Chiara CentonzeChiara Centonze6Malgorzata Gabriela WasniewskaMalgorzata Gabriela Wasniewska5
  • 1Dapartment of Translational Medical Sciensce, University of Naples Federico II, Naples, Italy
  • 2Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
  • 3Department of Mother and Child, Pediatric Unit, University Hospital, Messina, Italy
  • 4Department of Mother and Child, Pediatric Endocrinology Unit, University Hospital Federico II, Naples, Italy
  • 5Department of Human Pathology of Adulthood and Childhood, Pediatric Unit, University of Messina, Messina, Italy
  • 6Merk Serono SpA, Rome, Italy

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Acquired hypothyroidism is the most common thyroid disorder in children, with Hashimoto thyroiditis representing the leading cause in iodine-sufficient regions. Children and adolescents may present with a broad spectrum of clinical signs and symptoms, ranging in severity. Unusual or atypical presentations can complicate the differential diagnosis, potentially resulting in delays in both diagnosis and treatment, which may significantly impact growth and developmental outcomes. This review presents four real-life pediatric cases that illustrate both typical and atypical manifestations of acquired hypothyroidism. These cases are accompanied by a comprehensive overview of the condition's etiology, clinical presentation, diagnostic strategies, and management approaches in the pediatric population. The aim of this review is to summarize current knowledge on acquired hypothyroidism in children. By presenting real-world clinical cases, this review highlights key elements that can assist pediatricians in identifying and managing pediatric patients affected by this condition.

Keywords: Acquired hypothyroidism, Central hypothyroidism, Hashimoto Thyroiditis, Primary hypothyroidism, subclinical hypothyroidism

Received: 11 Nov 2025; Accepted: 12 Dec 2025.

Copyright: © 2025 Salerno, Capalbo, Valenzise, Di Mase, Morabito, Centonze and Wasniewska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mariacarolina Salerno
Donatella Capalbo

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material