ESPE Abstracts

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 (six–ten) 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 (4.5–10). 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.