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

Cristina Claret, Albert Goday, David Benaiges, Juan J. Chillarón, Juana A. Flores, Elisa Hernandez, Josep M. Corretger, Juan F. Cano

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    24 Citations (Scopus)

    Abstract

    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. © 2013 International Pediatric Research Foundation, Inc.
    Original languageEnglish
    Pages (from-to)674-678
    JournalPediatric Research
    Volume73
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2013

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