ESPE Abstracts

Introduction: Managing pediatric hypothyroidism with thyroxine therapy is crucial for children's growth and development. This presents a synthesized overview of the relationship between thyroxine therapy and growth outcomes in children with congenital and acquired hypothyroidism.Methods: A literature review from 1987 to 2013 was conducted, selecting studies on thyroxine therapy's effects on linear growth, cogni...

Introduction: Subclinical hypothyroidism (SH) in children and adolescents is a condition characterized by elevated thyroid-stimulating hormone (TSH) levels with normal serum free thyroxine (T4). The clinical significance and natural course of SH remain subjects of debate, necessitating a review of the literature to guide management decisions.Methods: This review analyzed ten studies, encompassing both observational cohor...

Introduction: Subclinical hypothyroidism (SCH) in children, characterized by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroxine (T4) levels, presents a clinical dilemma. The decision to treat SCH with L-thyroxine versus adopting a watchful waiting approach hinges on the potential benefits and drawbacks.Aim: This review synthesizes evidence from 20 studies to assess the impact of treatment versus...

Background: Thyroxine (T4) is critical in regulating growth and developmental processes. This review synthesizes 20 studies to examine thyroxine's effects on linear growth and development.Methods: A comprehensive review of the last two decades' research articles was conducted, selecting studies that examined thyroxine therapy on growth, development, and metabolic regulation in hypothyroid pediatric populations....

Introduction and Methods: We systemically reviewed the literature and analyzed key research papers from 1954 to 2023 on thyroxine action on growth and brain development.Results: (Table) Author(s): Year: Key Finding:...

Objective: To synthesize evidence on subclinical hypothyroidism (SH) in children, focusing on prevalence, diagnostics, treatment, and progression.Methods: Review of 28 studies including observational cohorts and clinical trials on pediatric SH.Results: SH in children is associated with increased risks of obesity, metabolic syndrome, non-alcoholic fatty liver disease (NAFLD) due to ...

Background: Chronic autoimmune thyroiditis (AT) is a leading cause for acquired primary hypothyroidism in children. The prevalence of the AT in pediatric age is lower than in adults - approximately 2%. Familial predisposition is well established, however exact pathophysiologic mechanism is still not known. Since the first signs of Hashimoto thyroiditis are nonspecific and challenging to recognize, also the disease is not associated with pediatric age, the diag...

Introduction: Children with Graves' disease (GD) show a set of characteristic clinical symptoms but data describing the chief complaints that led to the initial presentation are rare.Aims: To evaluate the spectrum of complaints of children with GD at initial presentation.Patients and Methods: We performed a retrospective review of the medical records of 148 children with bioch...

Introduction: Hashimoto's autoimmune thyroiditis is the primary cause of acquired hypothyroidism, with encephalopathy being a rare complication, particularly in children. Early and accurate diagnosis is crucial, as appropriate treatment is usually successful, while untreated cases can result in permanent impairment.Case presentation: A 17-year-old girl complained of numbness on the right side of her body and tongue,...

Van Wyk and Grumbach reported the association of untreated chronic hypothyroidism with precious puberty, pituitary enlargement and multicystic ovaries first in 1960. TRH-induced TSH excess causes macropituitary gland and stimulation of the gonadal FSH receptors, which explains the phenotype isosexual precious puberty and multi-cystic ovaries. In the following we report on two patients with this rare syndrome. The first patient is an 11 year old girl from Venezuela, who moved t...

İntroduction: Amiodarone, an iodine-rich antiarrhythmic agent, is associated with thyroid dysfunction in 15-20% of patients, potentially leading to amiodarone-induced thyrotoxicosis. The etiology of amiodarone-induced hyperthyroidism encompasses two distinct mechanisms: iodine-induced hyperthyroidism (Type 1) prevalent in patients with Graves' disease or nodular goiter, and destructive thyroiditis-induced hyperthyroidism (Type 2) observed in individu...

Introduction: Hypothyroidism in children and adolescents presents unique challenges to clinicians due to its diverse clinical manifestations, including important weight gain and growth deceleration. Hashimoto's Thyroiditis is the leading cause of thyroid disorders in the paediatric population.Case report: A 9-year-old girl was referred to our endocrinology department for significant weight gain (15-20% over 6 months...

Introduction: Brain-lung-thyroid syndrome (BLTS) is a rare autosomal dominant or de novo condition that occurs in early childhood, associated with mutations of the NKX2-1 (Thyroid transcription factor 1) gene present in chromosome 14q13. This protein plays a critical role during organogenesis of basal ganglia, lungs, including surfactant production and homeostasis, and thyroid. The clinical spectrum varies from the complete triad of brain-lung-thyroid...

Background: Management of subclinical hypothyroidism (SH) in infancy is still controversial. According to the European Guidelines for Congenital Hypothyroidism (CH), in case of TSH levels between 6 and 20 µUI/ml, both levothyroxine (L-T4) therapy and a wait-and-see approach can be considered.Aim: to describe the evolution of SH diagnosed in newborns recalled by neonatal screening (TSH values ≥7µUI/ml)....

Introduction: Graves' disease (GD) is an autoimmune hyperthyroidism characterized by the presence of TSH receptor antibodies (TRAb) present in 95% of cases. GD is the most common cause of exophthalmos, which is unilateral in 15% of cases, and falling within the framework of Graves orbitopathy (GO). GO concerns half of patients with GD. The presence of GO is very rare in patients with negative TRAb.Observation: This ...

Introduction: Rapid-onset Obesity with Hypothalamic dysfunction, Hypoventilation and Autonomic Dysregulation (ROHHAD) syndrome is a rare and complex disease that mortality is due to hypothalamic dysfunction and respiratory arrest. The aimof the study is to present a case of a patient with ROHHAD syndrome.Case Presentation: a 6-years old boy was consulted to Pediatrician OPC with obesity and snoring, starting in mid-2015....

Background: Iodine plays a priviledged role in the human body, allowing thyroid hormones syntesis, necessarry for appropriate energy levels for an active life. In children it plays role in early brain development and somatic growth, bone and pubertal maturation. The overall picture of iodine supply and eradication of Iodine Deficiency Disorders (IDD) is still cause of concern. The iodine status of regions is assessed by median urinary iodine concentrations (UI...

Introduction: The most common extra-thyroidal manifestation of Graves' disease is ophthalmic involvement. Pediatric Graves' ophthalmopathy (GO) occurs in approximately one-third of cases with pediatric Graves' disease. However, the frequency of severe GO is quite rare compared to adults, and in this case series, two different GO cases, one severe and one unilateral/asymmetric, are presented.Case 1: A 14-ye...

Background: Autoimmune thyroiditis, which can occur in chronic arthritis, involves the immune system attacking the thyroid gland, potentially causing hypothyroidism or hyperthyroidism. However, data on thyroid involvement in Still's disease remains limited, highlighting a significant gap in understanding the full spectrum of autoimmune and autoinflammatory interactions in this condition.The study aims: to examine th...

We present two cases of preterm newborns affected by autoimmune hyperthyroidism: patient A, a four-day-old male, and patient B, a seven-day-old female. Patient A was born at 33+6 gestational weeks (GW) by eutocic delivery; pregnancy was complicated by maternal autoimmune hypothyroidism. The mother was diagnosed with autoimmune thyroiditis eight years earlier, with positivity for anti- thyroperoxidase antibodies (TPOAb), in the absence of TSH receptor antibodies (TRAb). After a...

A was born at 38+4 weeks by eutocic delivery, with adequate auxological parameters and unremarkable perinatal history. She was admitted to our center at 15 days of life after the second screening for congenital hypothyroidism (CH) resulted positive (bTSH 48 mU/L); the first test was negative. Serum blood tests confirmed the diagnosis of CH (TSH 157 mU/L, FT4 0.96 ng/dl, FT3 8.44 pg/ml, negative thyroid autoimmunity). Thyroid ultrasound showed a gland of normal size. Therefore,...

Thyroid hormone (TH) plays an integral role in regulating homeostasis in the body throughout life. Adequate levels of TH are particularly important in utero and early infancy to ensure normal neurodevelopment. Triiodothyronine or T3 is biologically form of TH. Transport of T3 into the cell is facilitated by specific TH specific transporter proteins of which monocarboxylate transporter 8(MCT8) is well described. MCT8 is encoded by SLC16A2 on chromosome Xq13.2. Mutations in this...

Key words: autoimmune diseases, autoimmune thyroid disease, Hashimoto thyroiditis, Graves DiseaseIntroduction: Autoimmune diseases are significant and common health problem, which incidence in population increase. They affect 3- 5% of the general population, mainly females. The most common in children are: autoimmune thyroid disease (AITD) and type 1 diabetes mellitus (T1DM). AITD and T1DM are known from their prevalence...

Background: Atrophic thyroiditis is difficult to diagnose earlier due to asymptomatic or nonspecific symptoms, such as fatigue and headaches. Atrophic thyroiditis is frequently diagnosed in children with growth failure in school health examinations.Case: The case is a 14-year-old female with wobbles. She visited hospital, and blood test was performed. Hypothyroidism occurred with TSH of 657 µIU/mL and FT4 of <0....