Evaluation of the etiology of subclinical hypothyroidism in children
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Ayşe Yaşar
,
Esma Ebru Altun
,
Heves Kırmızıbekmez
and
Fatma Dursun
Abstract
Objectives
Subclinical hypothyroidism (SH) is defined by normal free triiodothyronine (fT3) and free thyroxine (fT4) levels, elevated thyroid-stimulating hormone levels, and the absence of overt clinical signs of hypothyroidism. The natural course of SH is influenced by the underlying etiology. The purpose of this study was to evaluate the etiologic causes of SH.
Methods
A total of 135 patients aged 1–18 years, diagnosed with SH by at least two analytical measurements, were included in the study. The anthropometric measurements, demographic characteristics, and laboratory findings of the patients were determined. A comparison was conducted between patients with Hashimoto’s thyroiditis and patients with non-autoimmune etiology.
Results
The median age was 9.7 (6.5) years, and 82 of the 135 patients were female. The most prevalent etiology was idiopathic, affecting 39 (28.9 %) patients. This was followed by obesity, which was identified in 21 (15.6 %) patients. Hashimoto’s thyroiditis was the third most common cause, accounting for 18 (13.3 %) patients. In patients with Hashimoto’s disease, fT4 levels were significantly lower, and the rate of initiation of LT4 treatment was higher than in patients with other etiologies. A heterozygous variation in the TSH receptor (TSHR) gene was detected in six patients.
Conclusions
In our study, idiopathic cases were the most frequently identified in the etiology of SH. It is important to determine whether there is autoimmune thyroiditis. In cases of idiopathic SH, it is recommended to perform TSHR gene analysis, particularly in the presence of positive family history and newborn screening results. This approach will help elucidate the underlying etiology.
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Research ethics: The study was performed according to the Helsinki II declaration and approved by the local Ethical Comitte.
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Informed consent: Not applicable.
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: The raw data can be obtained on request from the corresponding author.
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Articles in the same Issue
- Frontmatter
- Review
- Refractory hypothyroidism in children: an overview
- Original Articles
- Oral glucose tolerance test curve shape in Mexican children and adolescents with and without obesity
- Reliability of self-reported pubertal development scale for girls in early adolescent: a school population-based study
- Allergic reactions to enzyme replacement therapy in children with lysosomal storage diseases and their management
- The role of Cardiotrophin-1 and echocardiography in early detection of subclinical diabetic cardiomyopathy in children and adolescents with type 1 diabetes mellitus
- Evaluation of the etiology of subclinical hypothyroidism in children
- Long-term efficacy and safety of PEGylated recombinant human growth hormone in treating Chinese children with growth hormone deficiency: a 5-year retrospective study
- Case Reports
- Effective and safe use of sirolimus in hyperinsulinemic hypoglycaemia refractory to medical and surgical therapy: a case series and review of literature
- Diabetes and CFAP126 gene mutation; are they really linked together?
- Pronounced neonatal breast enlargement beyond the first week of life and its regression correlates with serum prolactin levels – a case series
- A successful liver transplantation in a patient with neonatal-onset carbamoyl phosphate synthetase-1 deficiency
- Corrigendum
- New data supporting that early diagnosis and treatment are possible and necessary in intracellular cobalamin depletion: the case of transcobalamin II deficiency
