Unveiling the hidden: acquired pediatric hypothyroidism

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.