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Follow-up in children with non-obese and non-autoimmune subclinical hypothyroidism
Zeynep Ergin1, Şenay Savaş-Erdeve2, Erdal Kurnaz2
1Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Disease Training and Research Hospital, Pediatrics, Ankara, Turkey.
Insights
Subclinical hypothyroidism in children often resolves within a year without treatment. This study found no adverse effects on growth, blood pressure, or metabolic markers in pediatric patients during follow-up.
Area of Science:
- Pediatric Endocrinology
- Thyroid Disorders
- Metabolic Health
Background:
- Subclinical hypothyroidism (SCH) in children requires evaluation of clinical, laboratory, and imaging findings.
- Understanding the clinical course of non-autoimmune SCH without goiter is crucial for management.
Purpose of the Study:
- To assess clinical, laboratory, and imaging characteristics of pediatric subclinical hypothyroidism.
- To determine the clinical course and outcomes of SCH in children over a one-year period.
Main Methods:
- Inclusion of 25 children (ages 3-18) with non-autoimmune SCH, normal BMI, and no goiter.
- Monitoring of thyroid-stimulating hormone (TSH), clinical parameters, and metabolic markers over 12 months.
Main Results:
- A significant recovery rate of 73.7% was observed for subclinical hypothyroidism.
- No significant changes in heart rate, diastolic blood pressure, lipid profile, glucose metabolism, or thyroid volume were noted.
- Systolic blood pressure and high-sensitivity C-reactive protein (hs-CRP) showed transient increases but remained similar within the study group.
Conclusions:
- Pediatric subclinical hypothyroidism generally does not progress to overt hypothyroidism within one year.
- Untreated SCH in children showed no detrimental impact on height, BMI, blood pressure, or glucose and lipid metabolism during the follow-up period.
Abstract:
Background The aim of our study was to evaluate clinical, laboratory and imaging findings and to have an idea about the clinical course of subclinical hypothyroidism in children. Methods Our study included 25 patients who were diagnosed with non-autoimmune subclinical hypothyroidism without goitre, between the ages of 3 and 18 and with body mass index (BMI) below the 85th percentile. Results The mean thyroid-stimulating hormone (TSH) level was 6.92±0.92 μIU/mL at diagnosis, 4.77±1.57 μIU/mL in the third month and 4.51±1.79 μIU/mL in the first year of follow-up. About 73.7% of subclinical hypothyroidism was recovered. There was no statistically significant difference between heart rate, diastolic blood pressure, lipid profile, fasting blood glucose (FBG), fasting insulin level, homeostatic model assessment of insulin resistance (HOMA-IR), hemoglobin, white blood cell, platelet, C-reactive protein (CRP) levels and thyroid volume at diagnosis and in the first year of follow-up. In the first year of follow-up, systolic blood pressure and high-sensitivity CRP value were significantly higher than at diagnosis. However, it was observed that these values were similar in the present group with subclinical hypothyroidism. Conclusions We concluded that there was no progression to overt hypothyroidism during 1-year follow-up and that subclinical hypothyroidism had no effect on height standard deviation score (SDS), BMI SDS, blood pressure, glucose and lipid metabolism during follow-up without treatment.
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