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Analysis of the factors affecting the evolution over time of subclinical hypothyroidism in children

Mariella Valenzise1, Tommaso Aversa1, Giuseppina Zirilli1

  • 1Department of Human Pathology of Adulthood and Childhood, University of Messina, via Consolare Valeria, 98125, Messina, Italy.

Italian Journal of Pediatrics
|January 5, 2017
PubMed

Insights

Subclinical hypothyroidism (SH) in children often resolves naturally, especially when idiopathic. However, children with Hashimoto

Area of Science:

  • Pediatric Endocrinology
  • Thyroidology
  • Internal Medicine

Background:

  • Subclinical hypothyroidism (SH) is a thyroid condition characterized by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroxine (T4) and triiodothyronine (T3) levels.
  • Understanding the natural history of SH is crucial for appropriate management strategies in pediatric populations.
  • Etiology plays a significant role in the progression and resolution of SH.

Discussion:

  • Idiopathic SH in children frequently shows a favorable natural course, with spontaneous resolution to euthyroidism or persistent SH over time.
  • In contrast, SH associated with Hashimoto's thyroiditis (HT) presents a higher risk of thyroid status deterioration.
  • The risk is further amplified in cases of HT-related SH combined with chromosomal abnormalities like Turner syndrome or Down syndrome.

Key Insights:

  • The natural history of pediatric subclinical hypothyroidism varies significantly based on its underlying cause.
  • Idiopathic SH has a generally benign prognosis, often resolving spontaneously.
  • Hashimoto's thyroiditis significantly increases the risk of progression in pediatric SH, especially when co-occurring with genetic syndromes.

Outlook:

  • Further research is needed to refine risk stratification for pediatric SH patients.
  • Longitudinal studies tracking outcomes in diverse pediatric SH populations are essential.
  • Personalized monitoring protocols based on etiology and associated conditions may improve patient outcomes.

Keywords:
ChromosomopathiesDown’s syndromeHashimoto’s thyroiditisThyroid functionThyroid statusTurner syndrome

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