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Prevalence and Determinants of True Thyroid Dysfunction Among Pediatric Referrals for Abnormal Thyroid Function

Amit Lahoti1, Jason Klein1, Tiffany Schumaker1

  • 1Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.

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|June 24, 2016
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Summary

Pediatric endocrinology referrals for abnormal thyroid function tests (TFTs) revealed a 20% hypothyroidism prevalence. Many patients did not require treatment, but elevated thyroid-stimulating hormone and antithyroglobulin antibodies predicted the need for intervention.

Keywords:
endocrinologyhypothyroidismreferralsthyroid dysfunctionthyroid function tests

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Area of Science:

  • Pediatric Endocrinology
  • Thyroidology
  • Clinical Diagnostics

Background:

  • Abnormalities in thyroid function tests (TFTs) are frequent reasons for pediatric endocrine referrals.
  • A significant number of these laboratory abnormalities do not necessitate treatment or ongoing endocrine management.
  • This highlights a need to differentiate true thyroid dysfunction from incidental findings.

Purpose of the Study:

  • To determine the prevalence of true thyroid dysfunction in children referred for abnormal TFTs.
  • To identify historical, clinical, and laboratory factors that predict the decision to initiate treatment.

Main Methods:

  • Retrospective chart review of pediatric patients evaluated for abnormal TFTs in 2010.
  • Analysis of demographic, clinical, and laboratory data to assess referral reasons and treatment decisions.

Main Results:

  • 230 patients were included, with a median age of 12 years; 56% were female.
  • Hypothyroidism was the primary evaluation reason for 206 patients, with elevated thyroid-stimulating hormone being the most common referral cause (n=140).
  • 20% of patients were diagnosed with hypothyroidism, and nearly one-third did not require thyroid follow-up.

Conclusions:

  • The prevalence of hypothyroidism in this pediatric referral group was 20%.
  • Elevated thyroid-stimulating hormone levels and the presence of antithyroglobulin antibodies were strong predictors for treatment decisions.
  • A substantial proportion of referrals for abnormal TFTs do not ultimately require therapeutic intervention or endocrine follow-up.