Down syndrome and thyroid function

Evan Graber1, Elizabeth Chacko, Molly O Regelmann

  • 1Division of Pediatric Endocrinology and Diabetes, Mount Sinai School of Medicine, New York, NY 10029, USA. evan.graber@mountsinai.org

Insights

Children with Down syndrome (DS) face early thyroid dysfunction risks, increasing with age due to autoimmunity. Annual screening is recommended, but definitions for mild thyroid issues need consensus.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Genetics

Background:

  • Thyroid dysfunction is common in children with Down syndrome (DS), starting at birth.
  • The risk of thyroid autoimmunity, including autoimmune hypothyroidism and Graves disease, rises with age in DS individuals.
  • Current thyroid screening protocols for DS patients lack universal consensus.

Purpose of the Study:

  • To review the prevalence and timing of thyroid dysfunction in children with Down syndrome.
  • To discuss the controversies surrounding optimal thyroid screening methods and frequency.
  • To highlight the need for standardized definitions of thyroid states in infants with DS.

Main Methods:

  • Literature review on thyroid screening in Down syndrome.
  • Analysis of current recommendations from pediatric and endocrine societies.
  • Discussion of diagnostic criteria for thyroid function.

Main Results:

  • Thyroid dysfunction can be present at birth in DS infants.
  • Autoimmune thyroid conditions are a significant concern as children with DS age.
  • The American Academy of Pediatrics advocates for annual thyroid screening.

Conclusions:

  • Early and ongoing thyroid monitoring is crucial for children with Down syndrome.
  • Standardized definitions for euthyroidism and mild hypothyroidism are essential for accurate diagnosis in DS infants.
  • Further consensus is required to refine screening strategies and diagnostic criteria.

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