Subclinical hypothyroidism in children: natural history and when to treat

Bona, Gianni; Prodam, Flavia; Monzani, Alice

doi:10.4274/jcrpe.851

Cited by 39 publications

(49 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 On the other hand, it is well known that SH may have a different outcome in idiopathic cases [21][22][23][24][25] and in those with an underlying HT. [26][27][28][29] It has clearly been shown that in children without HT or other thyroid diseases, DS may be associated with higher TSH levels, probably due to an inherent TSH setting disorder which seems to be peculiar to DS. 30 On the basis of such findings, these authors concluded that diagnosis of SH might be overestimated in DS and that L-T4 therapy in these patients should be contemplated only when TSH values are HT diagnosis due to the initial finding of a transient hyperthyroid biochemical picture, but at that time they had been negative.…”

Section: Resultsmentioning

confidence: 99%

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

Aversa¹,

Salerno²,

Radetti³

et al. 2015

View full text Add to dashboard Cite

BACKGROUND: Studies concerning presentation and evolution over time of Hashimoto's thyroiditis (HT) in children with Down's syndrome (DS) are few, are based on limited study populations and do not include control HT groups without DS. The aim of this multicenter study was to shed further light on the relationships between DS and HT in childhood. DE-SIGN: In this retrospective study we compared thyroid function patterns at HT presentation in 2 groups of children with (group A) or without DS (group B), including 146 and 553 cases, respectively. All group A patients were subsequently re-examined after a median interval of 5.1 years in order to prospectively re-evaluate the evolution over time of thyroid function patterns in DS. RESULTS: In group A, female predominance, age at HT diagnosis and rates of familiarity for thyroid diseases were significantly lower than in group B, whilst the association with non-thyroidal autoimmune diseases was more frequent. The hormonal patterns that were most frequently found in the 2 groups were, respectively, subclinical hypothyroidism (in group A) and euthyroidism (in group B). Thyroid dysfunctions were, overall, more frequent in group A (86.3 vs 45.7%, p<0.001). At re-evaluation, DS children exhibited further deterioration of thyroid function with some cases switching towards Graves' disease (GD). CONCLUSIONS HT in DS children: a) presents earlier, is not associated with female predominance and is more frequently associated with other autoimmune diseases; b) presents only very infrequently with a euthyroid hormonal profile; c) in a limited rate of cases switches with time to GD.

show abstract

Section: Resultsmentioning

confidence: 99%

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

Aversa¹,

Salerno²,

Radetti³

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In childhood, this is an even more controversial issue (6,7,8,9,10) and the only available study comparing the effects of L-T 4 treatment vs no therapy in idiopathic SH suggests that therapy is unable to modify post-therapy outcome of hyperthyrotropinemia and to prevent the risks of a subsequent TSH increase after treatment withdrawal (11). In the children with HT-related mild SH, it has been just recently reported that the evolution of thyroid function tests seems to be frequently characterized by a deterioration over time, whereas such risk is very low in the children with idiopathic SH (12).…”

Section: Introductionmentioning

confidence: 99%

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Waśniewska

Aversa

Salerno

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

Aim: To follow-up for 5 years thyroid status evolution in 127 girls with mild (TSH 5-10 mU/l) subclinical hypothyroidism (SH) of different etiologies. Patients: The population was divided into two age-matched groups of 42 and 85 girls with either idiopathic (group A) or Hashimoto's thyroiditis (HT)-related SH (group B). Group B was in turn divided into three subgroups, according to whether SH was either isolated or associated with Turner syndrome (TS) or Down syndrome (DS). Results: At the end of follow-up the rate of girls who became euthyroid was higher in group A (61.9% vs 10.6%), whereas the rates of patients who remained SH (55.3% vs 26.2%), became overtly hypothyroid (30.6% vs 11.9%) or required levothyroxine (L-T 4 ) therapy (63.5% vs 23.8%) were higher in group B. Among the girls of group B, the risk of remaining SH or developing overt hypothyroidism was higher in the subgroups with TS or DS than in those with isolated HT. Conclusions: Long-term prognosis of mild and idiopathic SH is frequently benign, even though a L-T 4 treatment may be needed throughout follow-up in almost a quarter of cases; long-term prognosis is different in the girls with either idiopathic or HT-related SH; and the association with either TS or DS impairs the outcome of HT-related SH.

show abstract

“…The decision about the treatment of SH in pediatric patients is still a matter of debate. None of the consensus statements published about the management of SH addressed the issue of SH in the pediatric population [6]. …”

Section: Introductionmentioning

confidence: 99%

Impaired Hemorheological Parameters and Increased Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism

Isik-Balci

Ağladıoğlu²,

Ağladıoğlu³

et al. 2016

Horm Res Paediatr

View full text Add to dashboard Cite

Background: Subclinical hypothyroidism (SH) is defined as elevated serum thyroid-stimulating hormone (TSH) concentration associated with normal serum-free thyroxine levels. Effects of hypothyroidism on hemorheology had widely attracted the attention of researchers during the last decade. Objective: The purpose of this study is to determine alterations in hemorheological parameters and carotid intima-media thickness (CIMT) in children with SH. Methods: Fifty-three SH children and 31 healthy controls were enrolled. Erythrocyte deformability and aggregation were determined by an ektacytometer and plasma viscosity (PV) by a cone-plate rotational viscometer. CIMT was evaluated sonographically. Results: Erythrocyte deformability of the SH group measured at 0.53 and 1.69-30 Pa was lower than that of the control group. The erythrocyte aggregation index, aggregation half time and PV were not different between the groups. However, the aggregation amplitude and mean corpuscular hemoglobin concentration were significantly higher in SH compared to the control group. There was a negative correlation between TSH and deformability values measured at 5.33-30.0 Pa. CIMT in patients with SH was significantly higher than in the control group (p = 0.001; SH = 0.48 ± 0.04 mm, control group = 0.43 ± 0.03 mm). Conclusion: Impaired hemorheology and increased CIMT are well-known risk factors for developing cardiovascular pathologies. The results of the current study suggest the treatment of children with SH in order to avoid early circulatory problems.

show abstract

Subclinical hypothyroidism in children: natural history and when to treat

Cited by 39 publications

References 37 publications

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Impaired Hemorheological Parameters and Increased Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism

Contact Info

Product

Resources

About