Subclinical Hypothyroidism in Children and Adolescents: A Wide Range of Clinical, Biochemical, and Genetic Factors Involved

Rapa, Anna; Monzani, Alice; Moia, Stefania; Vivenza, Daniela; Bellone, Simonetta; Petri, Antonella; Teofoli, Francesca; Cassio, Alessandra; Cesaretti, G; Corrias, Andrea; Sanctis, Vincenzo De; Maio, Salvatore Di; Volta, C.; Wasniewska, Malgorzata; Tatò, Luciano; Bona, Gianni

doi:10.1210/jc.2009-0375

Cited by 93 publications

(85 citation statements)

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“…In children with SH but with no goiter, negative antithyroid antibodies and TSH 5-10 mIU/l replacement therapy are not justified, both because of the low risk to develop an overt hypothyroidism and that they could simply be euthyroid outliers, representing 2.5% of normal individuals whose TSH values are above 97.5 th percentile of euthyroid distribution. It has to be taken into account that euthyroid outliers could be carriers of polymorphisms or mutations in genes of the thyroid hormone pathway such as TSH receptor, dual oxidase 2 (DUOX2), phosphodiesterase 8B, and TPO (56,57,58,59,60).…”

Section: Discussionmentioning

confidence: 99%

ENDOCRINE DISORDERS IN CHILDHOOD AND ADOLESCENCE: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review

Monzani

Prodam

Rapa

et al. 2013

European Journal of Endocrinology

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Objective: Subclinical hypothyroidism (SH) is quite common in children and adolescents. The natural history of this condition and the potential effects of replacement therapy need to be known to properly manage SH. The aim of this review is to analyze: i) the spontaneous evolution of SH, in terms of the rate of reversion to euthyroidism, the persistence of SH, or the progression to over hypothyroidism; and ii) the effects of replacement therapy, with respect to auxological data, thyroid volume, and neuropsychological functions. Methods: We systematically searched PubMed, Cochrane, and EMBASE (1990-2012) and identified 39 potentially relevant articles of which only 15 articles were suitable to be included. Results and conclusions: SH in children is a remitting process with a low risk of evolution toward overt hypothyroidism. Most of the subjects reverted to euthyroidism or remained SH, with a rate of evolution toward overt hypothyroidism ranging between 0 and 28.8%, being 50% in only one study (nine articles). The initial presence of goiter and elevated thyroglobulin antibodies, the presence of celiac disease, and a progressive increase in thyroperoxidase antibodies and TSH value predict a progression toward overt hypothyroidism. Replacement therapy is not justified in children with SH but with TSH 5-10 mIU/l, no goiter, and negative antithyroid antibodies. An increased growth velocity was observed in children treated with levothyroxine (L-T 4 ; two articles). L-T 4 reduced thyroid volume in 25-100% of children with SH and autoimmune thyroiditis (two studies). No effects on neuropsychological functions (one study) and posttreatment evolution of SH (one study) were reported.European Journal of Endocrinology 168 R1-R11

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Section: Discussionmentioning

confidence: 99%

ENDOCRINE DISORDERS IN CHILDHOOD AND ADOLESCENCE: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review

Monzani

Prodam

Rapa

et al. 2013

European Journal of Endocrinology

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“…dado que la frecuencia de hipotiroidismo en nuestro estudio fue superior a la descrita en población infantil general [10][11][12][13] , comparamos a los pacientes eutiroideos con los hipotiroideos en busca de diferencias en las características clínicas: no se encontró diferencia significativa en peso, imc, zimc, zt/e ni presencia de obesidad central. Creemos que esto se explicaría porque el zimc tiene bajo poder para predecir niveles de tsh (R 2 ajustado = 8,2%), aunque su influencia es significativa e independiente de las otras variables estudiadas.…”

Section: Discussionunclassified

“…la elevación leve de la hormona tiroestimulante (tsh) plasmática (hasta 10 µUi/ml) junto al resto de las hormonas tiroideas en rango normal (hipotiroidismo subclínico) es más frecuente en niños obesos, con prevalencias reportadas entre 7,5 y 23% [5][6][7] y asociación positiva entre TSH y el índice de masa corporal (imc) 8,9 . los estudios internacionales estiman una prevalencia de hipotiroidismo subclínico en la población pediátrica general entre 0,2 y 1,7% [10][11][12][13] . Fardella y col., encontraron una prevalencia de hipotiroidismo subclínico de 5,6% y un 6,8% de enfermedad tiroidea en población chilena adulta sana 14 , sin embargo, no existen estudios en población infantil chilena.…”

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Niveles de hormonas tiroideas en niños obesos

et al. 2014

Rev. chil. pediatr.

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“…TSH'nın düzeyleri yaşa, cinsiyete ve eşlik eden otoantikorlara göre değişiklik göstermektedir [4]. Birçok çalışmada TSH'nın üst sınırı 4,2m UI/L alınmaktadır (Tablo1) [5][6][7][8]. …”

Section: Introductionunclassified

Insidious danger in childhood era's: subclinical hypothyroidism

2017

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Insidious danger in childhood era's; subclinical hypothyroidism erleme d Öz Tiroid hormonları; santral sinir sistemi gelişimi, büyüme, gelişme, vücut ısısı regülasyonu, lipit, karbonhidrat ve enerji metabolizması, iskelet sistemi üzerinde önemli role sahiptir. Diğer yönden çocukluk çağında santral sinir sistemi myelinizasyonunda görevli olduğu için önemi farklıdır. Subklinik hipotiroidi, serum tiroid stimulan hormon seviyesinin orta düzeyde artması ile birlikte serum tiroid hormon seviyelerinin normal referans laboratuvar aralı-ğında olmasıdır. Çocuklarda %2 oranında görülmektedir. Etiyolojisinin büyük bir kısmını otoimmün tiroidit ve iyot eksikliği oluşturmaktadır. Asemptomatik olguların zamanında tanımlanması ve tedavisi önemlidir. Olgularda guatr, büyüme-gelişme geriliği veya duraksaması, ders başarısında azalma, negativizm, depresyon, obezite, demir eksikliği anemisi, dislipidemi, kemik yaşı geriliğinde levotiroksin tedavisi başlanması uygundur. Anahtar sözcükler: Çocukluk çağı, subklinik hipotiroidizm AbstractThyroid hormones have an important role on the central nervous system, growth, development, body temperature regulation, metabolism of lipid, carbohydrate and energy, musculoskeletal system. The other hand, it has a different importance for its role in the myelinization of the central nervous system during the childhood period. Subclinical hypothyroidism (SH), is diagnosed when peripheral thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone levels are mildly elevated. Prevalance of subclinical hypothyroidism in chilhood is seen about %2. The majority of its etiology is due to the autoimmune thyroiditis and iodine deficiency. It is important to diagnose and treat the asymptomatic cases in a timely manner. Thyroxin treatment should be started if goiter, growth velocity is slowed down, decline in school success, negativism, depression, obesity, refractory iron deficiency anemia dyslipidemia, bone age retardation.

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Subclinical Hypothyroidism in Children and Adolescents: A Wide Range of Clinical, Biochemical, and Genetic Factors Involved

Abstract: Overweight/obesity, thyroid hypoechogenicity, and nonsynonymous mutations in the TSH-R gene are characterizing features of a large portion of SH children.

Cited by 93 publications

References 40 publications

ENDOCRINE DISORDERS IN CHILDHOOD AND ADOLESCENCE: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review

ENDOCRINE DISORDERS IN CHILDHOOD AND ADOLESCENCE: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review

Niveles de hormonas tiroideas en niños obesos

Insidious danger in childhood era's: subclinical hypothyroidism

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