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Published on: February 9, 2024
Pediatric Hypothyroidism: Diagnosis and Treatment
1Thyroid Program, Division of Endocrinology, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. ari.wassner@childrens.harvard.edu.
Insights
Prompt diagnosis and treatment of infant hypothyroidism are crucial for development. This review covers causes, diagnosis, and management of congenital and acquired hypothyroidism in children, highlighting recent advances and uncertainties.
Area of Science:
- Pediatric Endocrinology
- Developmental Biology
Background:
- Thyroid hormone is vital for physiological functions, particularly in growth and neurodevelopment.
- Congenital hypothyroidism (CH) can lead to severe neurologic deficits if not promptly diagnosed and treated.
Purpose of the Study:
- To review current knowledge on the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children.
- To focus on recent developments and areas of uncertainty in pediatric hypothyroidism management.
Main Methods:
- Literature review of existing studies and clinical data on pediatric hypothyroidism.
- Synthesis of information on both congenital and acquired forms of the condition.
Main Results:
- Severe CH diagnosis and treatment are established, but milder forms require further research.
- Management of subclinical hypothyroidism in children presents ongoing uncertainties.
- Emerging data address genetic causes and prognosis of milder CH forms.
Conclusions:
- Accurate diagnosis and timely treatment of hypothyroidism in children are essential for optimal outcomes.
- Further research is needed to clarify the management of milder and subclinical forms of hypothyroidism in pediatric populations.
Abstract:
Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.
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