ESPE Abstracts (2015) 84 P-3-1205

ESPE2015 Poster Category 3 Thyroid (64 abstracts)

Subclinical Hypothyroidism in Children and Adolescents – A 5-year Single-center Follow-up Study

Aneta Gawlik a , Kamila Such c , Aleksandra Dejner c , Agnieszka Zachurzok a , Aleksandra Antosz b & Ewa Malecka-Tendera a

aPediatric Endocrinology and Diabetes, Department of Pediatrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; bPediatric Endocrinology and Diabetes, Department of Pediatrics, Upper-Silesian Pediatric Health Center, Katowice, Poland; cMedical Students’ Scientific Association, Katowice, Poland

Background: Most experts agree that subclinical hypothyroidism (SH) represents early, mild thyroid failure, however there are controversies about the evolution of SH over time.

Objective and hypotheses: The aim of the study was to analyse the dynamics of thyroid dysfunction in children initially referred as patients with SH.

Method: During the period January 2010 – January 2015, 258 unselected consecutive SH patients (140 girls), who met the criteria of SH: serum TSH concentration above the upper limit of the reference range with fT3 and fT4 concentration within their reference range, were studied in one clinical center. Thyroid examination (clinical and ultrasound), laboratory tests (TSH, fT4, fT3, anti-TPO, anti-TG Ab) were carried out at least once in each patient. Those individuals on pharmacological intervention that might interfere with natural evolution of SH (amiodarone, antiepileptic agents, glucocorticoids) were excluded.

Results: The mean age at SH diagnosis was 7.30 years (S.D. 5.44, medium 7.09 years; range: 0.0–17.86 years). SH girls were older than boys but not significantly (7.66±5.51 v 6.89±5.34; P=NS). In 25 (9.7%) patients there was positive family history. On the basis of follow-up study it was found that out of 258 SH patients, 23 (8.9%) had positive thyroid autoantibodies and Hashimoto thyroiditis was diagnosed. Eleven (4.3%) patients developed hypothyroidism, but only in two of them TSH levels were below 10 mU/l initially.

Conclusion: Our data confirmed that only a small percentage of children with SH can proceed to overt hypothyroidism.

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