ESPE Abstracts

Backgrounds/Aims: Studies related to changes in thyroid hormone metabolism in the course of chronic liver diseases have been conducted mostly in adults. In this study, we aimed to investigate the thyroid dysfunction in childhood chronic liver diseases.

Methods: Between 2005 and 2018, 960 chronic liver disease patient file that followed in our gastroenterology department are reviewed. Among all study subjects, 107 (53 female, 54 male) patients aged between 1 month and 18 age who were diagnosed as chronic liver disease and had thyroid function tests during diagnosis in their file, were enrolled in the study group. Anthropometric characteristics, laboratory data (ALT, AST, ALP GGT, total bilirubin, direct bilirubin, indirect bilirubin, albumin, total protein), and thyroid function test values were obtained from patient files.

Results: Of the 107 patients, 93 (86.9%) had normal thyroid function test and 10 (9.4%) had subclinical hypothyroidism and four (3.7%) had euthyroid sick syndrome. Of the 10 patients with subclinical hypothyroidism, two had glycogen storage diasease, three (30%) had biliary atresia, one had undiagnosed cholestatic liver disease, one had Alagille syndrome, one had chronic viral hepatitis, one had inborn errors of metabolism (galactosemia) and one had persistent elevated liver enzymes (idiopathic hepatitis). Spearman correlation analysis showed a negative correlation between free T3 and direct bilirubin (r = -0,329, P = 0,027).

Conclusion: In conclusion, euthyroid sick syndrome or subclinical hypothyroidism can be seen frequently in children with chronic liver diseases. Therefore, thyroid function tests should be evaluated in these cases at the diagnosis and monitoring. Moreover, this study is the first to show a negative correlation between free T3 levels and direct bilirubin, suggesting the association between the disease severity and the thyroid function test.

Keywords: Childhood chronic liver diseases, thyroid function test, euthyroid sick syndrome, subclinical hypothyroidism