Evaluation of Thyroid Function Tests in Children with Chronic Liver Diseases

Area of Science:

• Pediatric Endocrinology
• Hepatology
• Internal Medicine

Background:

• Limited research exists on thyroid function changes in pediatric chronic liver disease.
• Adult studies suggest a link between liver disease and thyroid dysfunction.

Purpose of the Study:

• To investigate the prevalence and types of thyroid dysfunction in children with chronic liver diseases.
• To explore potential correlations between liver disease severity and thyroid function parameters.

Main Methods:

• Retrospective analysis of 107 pediatric patients (aged 1 month to 18 years) with chronic liver disease from 2005-2018.
• Collection and analysis of anthropometric data, liver function tests, and thyroid function tests.
• Spearman correlation analysis to assess relationships between variables.

Main Results:

• Nearly 10% of pediatric patients exhibited thyroid dysfunction, primarily subclinical hypothyroidism (SH) or euthyroid sick syndrome.
• Specific liver conditions associated with SH included glycogen storage disease, biliary atresia, and Alagille syndrome.
• A significant negative correlation was observed between free tri-iodothyronine (fT3) and direct bilirubin levels (r=-0.329, p=0.027).

Conclusions:

• Thyroid dysfunction is a notable comorbidity in pediatric chronic liver disease, affecting up to 10% of cases.
• Routine thyroid function evaluation is advised at diagnosis and during follow-up for children with chronic liver conditions.
• The inverse relationship between fT3 and direct bilirubin suggests a potential link between liver disease severity and thyroid status in children.