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Thyroid Function in Children with Cyanotic and Non-Cyanotic Congenital Heart Disease

Mohammad Sadegh Fakhari1, Fatemeh Dorreh1, Mohammad Ahangar Davood2

  • 1Department of Pediatrics, Amir Kabir Hospital, Arak University of Medical Sciences Faculty of Medicine, Arak, Iran.

Turkish Archives of Pediatrics
|September 22, 2023
PubMed

Insights

Subclinical hypothyroidism is common in children with cyanotic congenital heart disease (CHD). This condition is linked to higher oxygen saturation, more severe cyanosis, and older age in these young patients.

Area of Science:

  • Pediatric Cardiology
  • Endocrinology
  • Neonatology

Background:

  • Congenital heart disease (CHD) is a prevalent childhood condition, categorized into cyanotic and non-cyanotic types.
  • CHD can disrupt thyroid function, leading to altered thyroid hormone secretion and hypofunction.
  • Evaluating thyroid function in infants with CHD is crucial for understanding potential endocrine complications.

Purpose of the Study:

  • To assess thyroid function in pediatric patients under two years old diagnosed with cyanotic or non-cyanotic CHD.
  • To identify the prevalence of thyroid dysfunction, including hypothyroidism and subclinical hypothyroidism, in this population.

Main Methods:

  • A cohort of 101 pediatric patients (50 female, 51 male) with CHD was studied.
  • Thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) levels were measured using electrochemiluminescence.
  • Thyroid peroxidase antibodies were quantified via ELISA; subclinical hypothyroidism was defined as normal T4 with elevated TSH.

Main Results:

  • Subclinical hypothyroidism occurred in 27.5% of cyanotic CHD patients, with 10% experiencing hypothyroidism.
  • Tetralogy of Fallot (30%) and patent ductus arteriosus (32.79%) were the most frequent diagnoses.
  • No significant differences in T3, T4, free T3, free T4, or anti-thyroid peroxidase antibody levels were observed between cyanotic and non-cyanotic groups.

Conclusions:

  • Subclinical hypothyroidism is a frequent finding in children with cyanotic CHD.
  • The prevalence of subclinical hypothyroidism in cyanotic CHD is associated with elevated oxygen saturation, increased cyanosis severity, and older age.
  • These findings highlight the importance of monitoring thyroid function in infants with cyanotic heart disease.
Abstract

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