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Related Concept Videos

Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...
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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Subclinical hypothyroidism in children.

M Shriraam1, M Sridhar

  • 1Department of Pediatrics, Apollo Childrens Hospital, Chennai. Correspondence to: Dr M Sridhar, Consultant Pediatrician, Apollo childrens Hospital, No. 15, Shafee Mohammed Road, Thousand Lights, Chennai 600 006, India. hemasridha@yahoo.co.uk.

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Summary

Subclinical hypothyroidism in children often requires only monitoring, not thyroid replacement therapy, especially when thyroid-stimulating hormone is below 10 mIU/L. Key risk factors for progression include female sex and positive thyroid antibodies.

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Area of Science:

  • Pediatric endocrinology
  • Thyroid disorders
  • Internal medicine

Background:

  • Subclinical hypothyroidism (SCH) is defined by elevated thyroid-stimulating hormone (TSH) with normal free T4, lacking overt symptoms.
  • Management strategies for pediatric SCH remain debated due to limited evidence.

Purpose of the Study:

  • To review current evidence on pediatric subclinical hypothyroidism.
  • To establish a consensus and management algorithm for this condition.

Main Methods:

  • A systematic literature search was conducted across PubMed, Cochrane, and Embase databases.
  • Included studies published between 1990 and 2014 focusing on pediatric subclinical hypothyroidism.
  • 13 relevant articles were selected for the review.

Main Results:

  • Pediatric subclinical hypothyroidism is frequently benign, often requiring only expectant management and monitoring.
  • Progression to overt hypothyroidism occurs less often than anticipated.
  • Thyroid replacement therapy is not indicated for TSH levels <10 mIU/L in children with SCH.

Conclusions:

  • Risk factors for progression to overt hypothyroidism include female sex, goiter, family history, positive thyroid peroxidase antibodies, and hypothyroid symptoms.
  • A suggested management algorithm emphasizes monitoring over immediate treatment.
  • Further robust randomized controlled trials focusing on clinical outcomes are needed.