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Subclinical hyperthyroidism and hyperkinetic behavior in children
P A Suresh1, S Sebastian, A George
1Section of Speech and Behavioural Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Insights
Subclinical hyperthyroidism in children can manifest as developmental learning disabilities (DLDs) and behavioral issues. Early thyroid screening in at-risk children may improve attention and learning outcomes.
Area of Science:
- Pediatric Endocrinology
- Developmental Neuroscience
- Behavioral Pediatrics
Background:
- Developmental learning disabilities (DLDs) are frequently associated with behavioral disturbances, including attention deficit and hyperactivity.
- Routine endocrinologic evaluations are often performed for children with DLDs.
Observation:
- Three children with DLDs presented with behavioral issues like attention deficit, hyperactivity, and autistic features.
- Thyroid function tests revealed subclinical hyperthyroidism in these children, despite the absence of overt systemic symptoms.
Findings:
- Treatment with neomercazole effectively managed hyperkinetic behavior and improved language function.
- Improvements were linked to enhanced attention spans, which facilitated speech therapy.
Implications:
- Selective thyroid screening in children with a family history of attention-deficit hyperactivity disorder (ADHD) or those with ADHD and DLDs is warranted.
- This approach may lead to earlier diagnosis and intervention for related behavioral and learning challenges.
Abstract:
The authors report three children who exhibited developmental learning disabilities (DLDs) associated with behavioral disturbances, such as attention deficit, hyperactivity, and autistic features. The thyroid function tests performed as a part of routine endocrinologic evaluation of children with DLDs revealed a hormonal profile consistent with hyperthyroidism. These children had no systemic signs of hyperthyroidism. Treatment with neomercazole resulted in good control of their hyperkinetic behavior and subsequent improvement in language function attributable to an increased attention span, thereby facilitating speech therapy. Although routine screening of all children with DLDs for thyroid dysfunction may not be cost-effective, selective screening of children with familial attention-deficit hyperactivity disorder and those with attention-deficit and hyperactivity in association with DLDs and pervasive developmental disorders appears to be justified.