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Thyroid Stimulating Hormone Level at Diagnosis as a Predictor of Persistent Subclinical Hypothyroidism in Children with Down Syndrome

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Abstract

Objective

To evaluate subclinical hypothyroidism in a cohort of children with Down syndrome and identify a TSH level at the time of diagnosis to predict persistent hypothyroidism.

Methods

192 children (age <3 years) with Down syndrome, registered in the Genetic Clinic of a referral tertiary care Hospital from 2010 to 2015 were evaluated with thyroid function test at initial visits and subsequently based on standard protocol. Children with subclinical hypothyroidism were evaluated at 3 years of age after discontinuation of thyroxine for 3 months.

Results

47 (24.5%) children had elevated TSH and among them 43 (91.5%) had subclinical hypothyroidism. Among the subclinical hypothyroidism group, 25 (73.5%) had transient hypothyroidism and 9 (26.5%) persistent hypothyroidism. Initial TSH level at the time of diagnosis was higher in persistent hypothyroidism group as compared to transient group (P= 0.003). The best cut-off level for prediction of persistent hypothyroidism for initial TSH level was 11.6 mIU/L.

Conclusion

Subclinical hypothyroidism, especially transient, is the commonest form of thyroid dysfunction in children with Down syndrome. The initial TSH level may help to predict the possibility of persistence of hypothyroidism.

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References

  1. Kariyawasam D, Carré A, Luton D, Polak M. Down synd-rome and nonautoimmune hypothyroidisms in neonates and infants. Horm Res Paediatr. 2015;83:126–31.

    Article  PubMed  CAS  Google Scholar 

  2. Tuysuz B, Beker DB. Thyroid dysfunction in children with Down syndrome. Acta Paediatr. 2001;90:1389–93.

    Article  PubMed  CAS  Google Scholar 

  3. Iughetti L, Predieri B, Bruzzi P, Predieri F, Vellani G, Madeo SF, et al. Ten-year longitudinal study of thyroid function in children with Down’s syndrome. Horm Res Paediatr. 2014;82:113–21.

    Article  PubMed  CAS  Google Scholar 

  4. Seshadri KG. Subclinical hypothyroidism in children. Indian J Endocrinol Metab. 2012;16:S156–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Unachak K, Tanpaiboon P, Pongprot Y, Sittivangkul R, Silvilairat S, Dejkhamron P, et al. Thyroid functions in children with Down syndrome. J Med Assoc Thai. 2008;91:56–61.

    PubMed  Google Scholar 

  6. Dayal D, Jain P, Panigrahi I, Bhattacharya A, Sachdeva N. Thyroid dysfunction in Indian children with Down syndrome. Indian Pediatr. 2014;51:751–2.

    Article  PubMed  Google Scholar 

  7. Claret C, Goday A, Benaiges D, Chillarón JJ, Flores JA, Hernandez E, et al. Subclinical hypothyroidism in the first years of life in patients with Down syndrome. Pediatr Res. 2013;73:674–8.

    Article  PubMed  CAS  Google Scholar 

  8. Kowalczyk K, Pukaj³o K, Malczewska A, Król-Chwastek A, Barg E. L-thyroxine therapy and growth processes in children with Down syndrome. Adv Clin Exp Med. 2013;22:85–92.

    PubMed  Google Scholar 

  9. Bull MJ. Committee on Genetics, Health Supervision for Children with Down Syndrome. Pediatrics. 2011;128: 393–406.

    Article  PubMed  Google Scholar 

  10. The Association of Clinical Biochemistry. UK Guidelines for the Use of Thyroid Function Tests, 2006. Available from: https://doi.org/www.british-thyroid-association.org. Accessed November 01, 2017.

  11. Dias VMA, Nunes JCR, Araújo SS, Goulart EMA. Etiological assessment of hyperthyrotropinemia in children with Down’s syndrome. J Pediatr (Rio J). 2005;81:79–84.

    Article  Google Scholar 

  12. Selikowitz M. A five-year longitudinal study of thyroid function in children with Down syndrome. Dev Med Child Neurol. 1993;35:396–401.

    Article  PubMed  CAS  Google Scholar 

  13. Gibson PA, Newton RW, Selby K, Price DA, Leyland K, Addison GM. Longitudinal study of thyroid function in Down’s syndrome in the first two decades. Arch Dis Child. 2005;90:574–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Konings CH, van Trotsenburg AS, Ris-Stalpers C, Vulsma T, Wiedijk BM, de Vijlder JJ. Plasma thyrotropin bioactivity in Down’s syndrome children with subclinical hypothyroidism. Eur J Endocrinol. 2001;144:1–4.

    Article  PubMed  CAS  Google Scholar 

  15. Van Trotsenburg AS, Kempers MJ, Endert E, Tijssen JG, de Vijlder JJ, Vulsma T. Trisomy 21 causes persistent congenital hypothyroidism presumably of thyroidal origin. Thyroid. 2006;16:671–80.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Government Medical College, Thiruvananthapuram, 695 011, Kerala, India

    Hariharan Vaikom Sankar, Krishnakumar Anjukrishna & Ismail Riaz

Authors
  1. Hariharan Vaikom Sankar
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  2. Krishnakumar Anjukrishna
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  3. Ismail Riaz
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Correspondence to Hariharan Vaikom Sankar.

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Sankar, H.V., Anjukrishna, K. & Riaz, I. Thyroid Stimulating Hormone Level at Diagnosis as a Predictor of Persistent Subclinical Hypothyroidism in Children with Down Syndrome. Indian Pediatr 55, 576–578 (2018). https://doi.org/10.1007/s13312-018-1300-x

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  • DOI: https://doi.org/10.1007/s13312-018-1300-x

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