Background: The hypothyroidism is defined by an elevated TSH with normal fT4 and the absence of symptoms of hormonal deficiency. In children and adolescents, it is mainly due to chronic thyroiditis or radiotherapy for cervical cancer.
Objective and hypotheses: Assess clinical, etiological and evolutionary characteristics of subclinical hypothyroidism in children and adolescents.
Method: This is a retrospective and prospective study of 25 cases of children and adolescents with subclinical hypothyroidism. All patients underwent a clinical examination, hormonal assment: FT4, TSHus, AC anti TPO, cervical ultrasound and lipid exploration Clinical and laboratory tests were performed annually.
Results: The average age is 8 years (sixten) in children (eight girls, five boys) and 14.5 years among adolescents (seven girls and six boys).The reason for consultation was -In children: stature delay (50%) and goitre (50%). In Teenagers: Goitre (40%), signs of hypothyroidism (20%), a systematic exploration (40%); 60% of patients had a goitre with positivity for anti TPO AC. Patients without goitre had no markers of autoimmunity. The clinical exam was normally except for a stature delay in 30% and asthenia in 10%. The lipid profile was normal in all cases. The mean TSH was 8.8 μ/l (4.510). Etiological, it was a Hashimoto thyroiditis in 60% of cases and a post radiotherapy hypothyroidism in 15% of cases. No etiology was found in the other cases. Monitoring patients revealed after a mean follow of 6yrs the transition to frank hypothyroidism in 30% of cases, normalising hormone function in 40% of cases and stabilization in the remaining cases.
Conclusion: Subclinical hypothyroidism is a rare disease in the child and adolescent. Its development is characterised in most cases by a normalisation of TSH or its stability. In a few cases a frank hypothyroidism appears.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology