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[Thyroid function in severely disabled children].

M Kimura1, M Kato, K Yoshino

  • 1Department of Pediatrics, National Sanatorium, Nishi-Tottori Hospital.

No to Hattatsu = Brain and Development
|January 1, 1991
PubMed
Summary

Thyroid function abnormalities are common in severely disabled children, often linked to anticonvulsant medications. Supplementation with L-thyroxine did not improve symptoms in patients with low thyroid hormone levels.

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Area of Science:

  • Pediatric Endocrinology
  • Clinical Chemistry
  • Neurology

Context:

  • Thyroid dysfunction evaluation in pediatric populations.
  • Impact of chronic illness and medication on endocrine function.
  • Assessment of thyroid hormone levels in severely disabled children.

Purpose:

  • To investigate the prevalence and causes of thyroid function abnormalities in severely disabled children.
  • To determine the relationship between anticonvulsant use and thyroid hormone levels.
  • To evaluate the efficacy of L-thyroxine supplementation in affected children.

Summary:

  • Fifty-three percent of 105 severely disabled children exhibited abnormal thyroid function tests.
  • Anticonvulsant medications were identified as the primary cause of these abnormalities, with serum T4 levels correlating with the number of anticonvulsants used.

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  • Two cases of primary hypothyroidism and two suspected cases of subclinical hypothalamic-pituitary hypothyroidism due to septo-optic dysplasia were identified.
  • L-thyroxine supplementation in four patients with low T4 or low T4/T3 levels yielded no clinical improvement, with decreased TSH and hyporeaction on TRH testing observed.
  • Low T3 syndrome, unrelated to anticonvulsants, was noted in two patients with poor nutritional status.
  • Impact:

    • Highlights the significant prevalence of thyroid dysfunction in severely disabled children.
    • Underscores the etiological role of anticonvulsant drugs in pediatric thyroid abnormalities.
    • Suggests limitations of L-thyroxine supplementation in certain thyroid dysfunction scenarios within this population.
    • Informs clinical practice regarding thyroid monitoring and management in neurologically impaired children.