Startseite Medizin Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years
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Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years

  • Inês Moreira Esteves , Rita Aldeia da Silva ORCID logo EMAIL logo , Mariana Oliveira Pereira ORCID logo , Mariana Portela ORCID logo , Olinda Marques , Sofia Martins ORCID logo , Ana Antunes ORCID logo , Aurélio Mesquita und Maria Miguel Gomes ORCID logo
Veröffentlicht/Copyright: 3. Januar 2025
Journal of Pediatric Endocrinology and Metabolism
Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 38 Heft 2

Abstract

Objectives

Subclinical hypothyroidism (SCH) is defined by elevated thyroid-stimulating hormone (TSH) levels (>5 mUI/L) and normal total and free thyroxine levels (fT4). There is ongoing debate over whether mild SCH should be treated. This study aims to assess the clinical course of normoponderal pediatric patients with SCH.

Methods

Retrospective study, involving normoponderal children and adolescents with SCH, followed at the Pediatrics Department of Hospital de Braga, from December 2007 to December 2022.

Results

We identified 47 children and adolescents with confirmed SCH. No sex predominance was found. The median age at diagnosis was 11 years. Most cases were idiopathic (59.6 %) and diagnosed during puberty (57.5 %). The majority (46.8 %) experienced spontaneous remission, while 38.3 % required levothyroxine (LT) therapy. Discharged patients were followed for a median of 25 months. No significant differences were seen in body mass index z-score, fT4 levels, heart rate, blood pressure, or lipid parameters. Significant differences were found in thyroid-stimulating hormone (TSH) levels and LT dosage. Thyroid peroxidase antibody (TPOAb) positivity was significantly correlated with SCH’s natural history. Although initial TSH levels were not significantly associated with SCH’s natural course, they predict treatment need. Individuals with initial TSH levels >6.47 mUI/L were more likely to require therapy. In the third year of follow-up, a significant strong negative correlation was found between TSH levels and high-density lipoprotein cholesterol.

Conclusions

SCH was self-limiting and benign in most cases. TPOAb positivity was a predictor of SCH’s natural history, and the need for treatment was predicted by initial TSH levels.

Keywords: levothyroxine; normoponderal; subclinical hypothyroidism; thyroid-stimulating hormone; thyroxine
Corresponding author: Rita Aldeia da Silva, Pediatric Resident Doctor, Pediatrics Department, Unidade Local de Saúde de Braga, Rua das Sete Fontes, 4710-243 Braga, Portugal, E-mail:

  1. Research ethics: The local Institutional Review Board deemed the study exempt from review.

  2. Informed consent: Informed consent was obtained from all individuals included in this study.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: Not applicable.

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Received: 2024-07-15
Accepted: 2024-12-07
Published Online: 2025-01-03
Published in Print: 2025-02-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Original Articles
  3. Effects of orlistat on body mass index and serum lipids in overweight and obese adolescents: a meta-analysis
  4. Psychological and behavioral assessments in girls with idiopathic central precocious puberty
  5. The effect of phlebotomy and placement of an intravenous catheter on plasma catecholamine and serum copeptin concentrations
  6. Laparoscopic adrenalectomy in children with diverse adrenal pathologies: the impact of pre-operative imaging in decision making process
  7. Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years
  8. Newborn screening follow-up in Bavaria: height and weight in paediatric patients with congenital adrenal hyperplasia
  9. Patterns and determinants of serum amylase, lipase concentrations in Indian adolescents and youth with type 1 diabetes
  10. Pediatric Graves’ disease in Argentina: analyzing treatment strategies and outcomes
  11. Nephrogenic diabetes insipidus results from a novel in-frame deletion of AVPR2 gene in monozygotic-twin boys and their mother and grandmother
  12. Short Communication
  13. Does clonidine stimulate copeptin in children?
  14. Case Report and Review of the Literature
  15. Sialidosis type 1 in a Turkish family: a case report and review of literatures
  16. Case Reports
  17. Central precocious puberty in a toddler with hypothalamic hamartoma
  18. Autosomally dominantly inherited isolated gonadotropin deficiency via maternal assisted reproduction due to SOX10 mutation
  19. Unclear symptoms, early diagnosis and perfect outcome: a case diagnosed as sepiapterin reductase deficiency hidden behind vitamin B12 deficiency
https://doi.org/10.1515/jpem-2024-0341
Schlagwörter für diesen Artikel
levothyroxine; normoponderal; subclinical hypothyroidism; thyroid-stimulating hormone; thyroxine

Artikel in diesem Heft

  1. Frontmatter
  2. Original Articles
  3. Effects of orlistat on body mass index and serum lipids in overweight and obese adolescents: a meta-analysis
  4. Psychological and behavioral assessments in girls with idiopathic central precocious puberty
  5. The effect of phlebotomy and placement of an intravenous catheter on plasma catecholamine and serum copeptin concentrations
  6. Laparoscopic adrenalectomy in children with diverse adrenal pathologies: the impact of pre-operative imaging in decision making process
  7. Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years
  8. Newborn screening follow-up in Bavaria: height and weight in paediatric patients with congenital adrenal hyperplasia
  9. Patterns and determinants of serum amylase, lipase concentrations in Indian adolescents and youth with type 1 diabetes
  10. Pediatric Graves’ disease in Argentina: analyzing treatment strategies and outcomes
  11. Nephrogenic diabetes insipidus results from a novel in-frame deletion of AVPR2 gene in monozygotic-twin boys and their mother and grandmother
  12. Short Communication
  13. Does clonidine stimulate copeptin in children?
  14. Case Report and Review of the Literature
  15. Sialidosis type 1 in a Turkish family: a case report and review of literatures
  16. Case Reports
  17. Central precocious puberty in a toddler with hypothalamic hamartoma
  18. Autosomally dominantly inherited isolated gonadotropin deficiency via maternal assisted reproduction due to SOX10 mutation
  19. Unclear symptoms, early diagnosis and perfect outcome: a case diagnosed as sepiapterin reductase deficiency hidden behind vitamin B12 deficiency
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