ESPE Abstracts (2019) 92 P3-160

Thyroid Dysfunction in the First Year of Life in Infants with Down syndrome: Linear Growth Over 4 Years

Nada Alaaraj, Ashraf Soliman, Maya Itani, Shayma Mohamed, Ahmed Khalil, ashraf adel


Hamad General Hospital, Doha, Qatar


Background: Down syndrome (DS) is associated with thyroid dysfunction including both congenital and acquired hypothyroidism (HT) However, data about thyroid function in infants < 1 year with DS is scarce.

The aim of this study was to investigate the prevalence of different thyroid dysfunctions in a cohort of infants with DS (n = 47) (22 M, 25 F) and follow up their linear growth and weight gain for an average of 4 years.

Patients and Methods: Retrospectively we studied thyroid function in a cohort of infants with DS (n = 47) (below 1 year) and followed up their linear growth and weight gain (height SDS (HtSDS), delta HtSDS, BMISDS, and delta BMISDS) for an average of 4 years.

Results: presented in 2 tables

Table 1: Prevalence of thyroid dysfunction in infants with DS < 1 year of age
Prevalence in DS
Number47
Age, Mean (years)0.5+/-0.3
Primary Hypothyroidism (low FT4 + high TSH)1/47 (2%)
TSH > 15 mIU/L5/47 (11%)
Central hypothyroidism2/47 (4%)
TSH >5 and <15 mIU/L (subclinical hypothyroidism)23/47 (49%)
TSH < 5 mIU/L19/47 (40%)
Positive Anti Thyroid antibodies9/47 (19%)
Other autoimmune disorders/antibodies1/47 (2%)
Type 1 DM1/47 (2%)
Congenital heart Disease (CHD)36/47
Table 2: Growth of Children with DS categorized according to their primary thyroid function
Groupsage 1LSD1BMISDS1age 2LSD2BMISDS2Delta HTSDSDelta BMISDS
TSH >5-<15Mean0.48-1.46-1.044.41-1.990.43-0.531.43
SDS0.381.281.384.250.811.141.161.63
TSH <5Mean0.54-1.75-0.992.54-1.820.33-0.071.32
SDS0.392.511.331.001.531.621.432.14
TSH >15Mean0.29-2.43-2.77*4.46-2.240.690.203.46*
SDS0.311.701.764.690.740.751.722.33
*P<0.05

Conclusion: Infants with DS < 1 year of age had a high prevalence of thyroid dysfunction. Subclinical HT (TSH > 5 and normal FT4) is the most frequent abnormality in these infants. Both primary and secondary HT are found in these infants. Autoimmunity against thyroid was detected in 19 % of these young infants (early autoimmunity). Infants with TSH > 15 had significantly lower BMISDS and were non-significantly shorter than the other groups (P= 0.03 and P =0.14 respectively). Infants with TSH> 15 mIU/L were treated with L thyroxine. After an average of 4 years of treatment, the BMISDS and HtSDS did not differ among the 3 groups.

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