Longitudinal study of thyroid function in Down's syndrome in the first two decades

Gibson, Peter; Newton, Richard; Selby, Kathryn; Price, D A; Leyland, Kath; Addison, G. M.

doi:10.1136/adc.2004.049536

Cited by 114 publications

(98 citation statements)

References 20 publications

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“…23 Gibson PA et al also observed that 47% of subclinical hypothyroid Down's syndrome patients were subsequently found to have normal TSH levels after a gap of four to six years. 24 We do not know whether our cases are transient type or not, as we could not follow up the enrolled cases.…”

Section: Discussionmentioning

confidence: 99%

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Biswas

Munsi

Hussain

et al. 2017

Bangladesh J Child Health

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Section: Discussionmentioning

confidence: 99%

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Biswas

Munsi

Hussain

et al. 2017

Bangladesh J Child Health

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“…This phenomenon, of uncertain etiology, can be referred to as subclinical hypothyroidism (SH) and seems usually to be transitory and self-limiting without treatment (9,10). However, there are few systematic studies on SH, and the factors related to its remission are unclear.…”

Section: T He Prevalence Of Medical Conditions In Individuals Withmentioning

confidence: 99%

Subclinical hypothyroidism in the first years of life in patients with Down syndrome

et al. 2013

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Background: subclinical hypothyroidism (sh), defined as mild thyroid-stimulating hormone (Tsh) elevation with normal free thyroxine (FT4) levels and no symptoms, is common during the first few years of life in Down syndrome (Ds) and can be self-limiting. Our objective was to confirm that sh is usually a transitory disorder and to identify the factors associated with spontaneous remission. Methods: We reviewed clinical histories of patients from the catalan Down syndrome Foundation (cDsF) with Ds and sh diagnosed before 5 y of age. sh was defined as Tsh 5.5-25 µU/ml (6 mo-4 y) or 4.13-25 µU/ml (4-7 y), with FT4 0.89-1.87 ng/dl (6 mo-4 y) or 0.96-1.86 ng/dl (4-7 y). results: Fifty-three patients with sh were identified, with an average age of 2.4 ± 1.1 y, median (range) Tsh at diagnosis 7.1 (4.2-23.9 µU/ml), and median (range) FT4 1.1 (0.9-1.7 ng/dl). sh resolved spontaneously in 39 cases (73.6%), with Tsh at the most recent visit (mean age 6.7 ± 1.4 y) 3.9 (1.8-12.7 µU/ml). The rate of remission was significantly higher in patients without goiter (94.9 vs. 28.6%) and in those who were negative for antithyroid antibodies (89.7 vs. 42.9%). conclusion: sh in infants and preschool children with Ds is usually a transitory disorder, with remission in >70% of cases. The absence of goiter and thyroid autoantibodies was associated with a greater rate of spontaneous remission in our study. t he prevalence of medical conditions in individuals withDown syndrome (DS) is greater than in the general population, which has negative implications for their quality of life and life expectancy (1). Among these medical problems, thyroid pathology is a primary area of concern. Both hyper-and hypothyroidism occur more often in patients with DS (1-3), the latter disorder occurring six times more frequently than the former (4,5).In addition to the increased risk of developing autoimmune hypothyroidism with age (2,6), children with DS have a higher chance of displaying a mild, isolated increase in thyroid-stimulating hormone (TSH) in the absence of low free thyroxine (FT4) or overt hypothyroid symptoms (7,8). This phenomenon, of uncertain etiology, can be referred to as subclinical hypothyroidism (SH) and seems usually to be transitory and self-limiting without treatment (9,10). However, there are few systematic studies on SH, and the factors related to its remission are unclear. The possibility that thyroxine replacement may have a beneficial effect on the somatic and psychomotor development of patients with DS and SH has been raised (11). In this context, the results of a randomized, double-blind clinical trial with 196 DS children are important with respect to previous studies. On the basis of the theory that all DS subjects have slight hypothyroidism at birth (12,13), this study evaluated the effect of systematic treatment with levothyroxine initiated in the neonatal period and continued during the first 2 y of life, as compared with that of placebo. Treatment with levothyroxine resulted in a subtle improvement in psychomotor developme...

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“…Blood samples were taken from 30 nondiabetic schoolaged children with Down's syndrome (15 male and 15 female, 4 -21 years of age) during routine thyroid screening in the area covered by the Gloucestershire Health Authority, U.K. Aliquots of DNA samples from 83 children with Down's syndrome had been collected as part of a study of congenital heart disease in Down's syndrome (15). Samples were also available (109 DNA and 106 serum) for analysis from a population-based study of children with Down's syndrome in Manchester, the Hester Adrian Research Centre cohort (16). There was no clinical evidence of diabetes in any of these children.…”

Section: Methodsmentioning

confidence: 99%

Islet Autoimmunity in Children With Down’s Syndrome

et al. 2006

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There is an unexplained excess of type 1 diabetes and other organ-specific autoimmune diseases in children with Down's syndrome, but the immunogenetic characteristics of diabetes in Down's syndrome have not been investigated. We studied the frequency of islet autoantibodies in 106 children with Down's syndrome and no history of autoimmunity and analyzed HLA class II genotypes in 222 children with Down's syndrome, 40 children with Down's syndrome and type 1 diabetes, 120 age-and sex-matched children with type 1 diabetes, and 621 healthy control subjects. Co-occurrence of at least two islet autoantibody markers was observed in 6 of 106 nondiabetic children with Down's syndrome compared with 13 of 2,860 healthy agematched children (P < 0.001). There was an excess of diabetes-associated HLA class II genotypes in children with Down's syndrome and type 1 diabetes compared with ageand sex-matched healthy control subjects (P < 0.001). Down's syndrome children with type 1 diabetes were, however, less likely to carry the highest risk genotype DR4-DQ8/DR3-DQ2 than children with type 1 diabetes from the general population (P ‫؍‬ 0.01) but more likely to carry low-risk genotypes (P < 0.0001). The frequency of subclinical islet autoimmunity is increased in Down's syndrome, and susceptibility to type 1 diabetes in Down's syndrome is partially HLA mediated. Other factors, possibly including genes on chromosome 21, may increase the penetrance of type 1 diabetes in Down's syndrome. Diabetes 55: [3185][3186][3187][3188] 2006

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Longitudinal study of thyroid function in Down's syndrome in the first two decades

Cited by 114 publications

References 20 publications

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Subclinical hypothyroidism in the first years of life in patients with Down syndrome

Islet Autoimmunity in Children With Down’s Syndrome

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Longitudinal study of thyroid function in Down's syndrome in the first two decades

Cited by 114 publications

References 20 publications

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Subclinical hypothyroidism in the first years of life in patients with Down syndrome

Islet Autoimmunity in Children With Down’s Syndrome

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Product

Resources

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Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome

Functional Status of Thyroid Gland in Hospitalized Children With Downs Syndrome