본문 바로가기
KERD
논문KCI 등재

Subclinical hypothyroidism in children: updates for pediatricians

Metwalley Kotb Abbass|Farghaly Hekma Saad
대한소아내분비학회 (Korean Society Of Pediatric Endocrinology)|2021.06|Annals of Pediatric Endocrinology & Metabolism|제26권 제2호|pp. 80-85|DOI 10.6065/apem.2040242.121

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

LevothyroxineSubclinical hypothyroidismHashimoto’s thyroiditisThyroid-stimulating hormoneThyroid autoantibodies
주제분류소아과학

초록

Subclinical hypothyroidism (SH) is defined as serum thyroid-stimulating hormone (TSH) above the upper limit of the reference range in the presence of normal free T4 concentrations. Depending on the degree of TSH elevation, SH could be defined as mild (TSH, 4.5–10 mIU/L) or severe (TSH>10 mIU/L). While there is a general consensus to treat children with serum TSH levels above 10 mU/L, the management of the mild form is uncertain and should be individualized. In this mini-review, we present a brief review of SH in children based on extensive literature review and long-standing clinical experience. This review provides the prevalence, causes, clinical presentation, consequences, investigation, and up-to-date therapeutic approach of SH in children. Generally, the purpose of the review is to provide pediatricians with an update of this common and continuously evolving condition.

Abstract

Subclinical hypothyroidism (SH) is defined as serum thyroid-stimulating hormone (TSH) above the upper limit of the reference range in the presence of normal free T4 concentrations. Depending on the degree of TSH elevation, SH could be defined as mild (TSH, 4.5–10 mIU/L) or severe (TSH>10 mIU/L). While there is a general consensus to treat children with serum TSH levels above 10 mU/L, the management of the mild form is uncertain and should be individualized. In this mini-review, we present a brief review of SH in children based on extensive literature review and long-standing clinical experience. This review provides the prevalence, causes, clinical presentation, consequences, investigation, and up-to-date therapeutic approach of SH in children. Generally, the purpose of the review is to provide pediatricians with an update of this common and continuously evolving condition.

참고문헌 (50)

  1. Crisafulli G, "Subclinical hypothyroidism in children : when a replacement hormonal treatment might be advisable", Front Endocrinol(Lausanne), 10, pp.109~ (2019)
  2. Van Deventer HE, "Inverse log-linear relationship between thyroid-stimulating hormone and free thyroxine measured by direct analog immunoassay and tandem mass spectrometry", Clin Chem, 57, pp.122~127 (2011)
  3. Biondi B, "Subclinical hypothyroidism : a review", JAMA, 322, pp.153~160 (2019)
  4. Cooper DS, "Subclinical thyroid disease", Lancet, 379, pp.1142~1154 (2012)
  5. Salerno M, "Subclinical hypothyroidism in childhood-current knowledge and open issues", Nat Rev Endocrinol, 12, pp.734~746 (2016)
  6. Gopalakrishnan S, "Goitrous autoimmune thyroiditis in a pediatric population : a longitudinal study", Pediatrics, 122, pp.e670~e674 (2008)
  7. 이윤정, "Unfavorable Course of Subclinical Hypothyroidism in Children with Hashimoto’s Thyroiditis Compared to Those with Isolated Non-Autoimmune Hyperthyrotropinemia", Journal of Korean Medical Science, 32(1), pp.124~129 (2017), 대한의학회
  8. Brown RS, "Autoimmune thyroiditis in childhood", J Clin Res Pediatr Endocrinol, 5(Suppl 1), pp.45~49 (2013)
  9. Nicoletti A, "Thyrotropin-stimulating hormone receptor gene analysis in pediatric patients with non-autoimmune subclinical hypothyroidism", J Clin Endocrinol Metab, 94, pp.4187~4194 (2009)
  10. Abe K, "Association between monoallelic TSHR mutations and congenital hypothyroidism : a statistical approach", Eur J Endocrinol, 178, pp.137~144 (2018)
  11. Cassio A, "Current loss-of-function mutations in the thyrotropin receptor gene: when to investigate, clinical effects, and treatment", J Clin Res Pediatr Endocrinol, 5(Suppl 1), pp.29~39 (2013)
  12. De Marco G, "Identification and functional analysis of novel dual oxidase 2(DUOX2)mutations in children with congenital or subclinical hypothyroidism", J Clin Endocrinol Metab, 96, pp.E1335~E1339 (2011)
  13. King K, "Thyroid dysfunction in children with Down syndrome : a literature review", Ir J Med Sci, 183, pp.1~6 (2014)
  14. Aversa T, "Peculiarities of presentation and evolution over time of Hashimoto's thyroiditis in children and adolescents with Down's syndrome", Hormones, 14, pp.410~416 (2015)
  15. Grossi A, "Endocrine autoimmunity in Turner syndrome", Ital J Pediatr, 39, pp.79~ (2013)
  16. Deladoëy J, "Is the incidence of congenital hypothyroidism really increasing? A 20-year retrospective population-based study in Québec", J Clin Endocrinol Metab, 96, pp.2422~2429 (2011)
  17. Buluş AD, "Evaluation of neurodevelopment of children with congenital hypothyroidism by the Denver Developmental Screening Test", J Pediatr Endocrinol Metab, 30, pp.1061~1066 (2017)
  18. Reinehr T, "Thyroid function in the nutritionally obese child and adolescent", Curr Opin Pediatr, 23, pp.415~420 (2011)
  19. Reinehr T, "Thyroid hormones before and after weight loss in obesity", Arch Dis Child, 87, pp.320~323 (2002)
  20. Gökdeniz E, "The effects of iron deficiency anemia on the thyroid functions", J Clin Exp Invest, 1, pp.156~160 (2010)
  21. Metwalley KA, "Thyroid status in Egyptian primary school children with iron deficiency anemia : relationship to intellectual function", Thyroid Res Pract, 10, pp.91~95 (2013)
  22. Afroz S, "Thyroid function in children with nephrotic syndrome", Mymensingh Med J, 20, pp.407~411 (2011)
  23. Benvenga S, "Do not forget nephrotic syndrome as a cause of increased requirement of levothyroxine replacement therapy", Eur Thyroid J, 4, pp.138~142 (2015)
  24. Lazar L, "Natural history of thyroid function tests over 5 years in a large pediatric cohort", J Clin Endocrinol Metab, 94, pp.1678~1682 (2009)
  25. Wasniewska M, "Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence", Eur J Endocrinol, 160, pp.417~421 (2009)
  26. Shrestha U, "Iodine status among subclinical and overt hypothyroid patients by urinary iodine assay : a case-control study", Indian J Endocrinol Metab, 21, pp.719~723 (2017)
  27. Kang MJ, "Excessive iodine intake and subclinical hypothyroidism in children and adolescents aged 6-19 years : results of the Sixth Korean National Health and Nutrition Examination Survey, 2013-2015", Thyroid, 28, pp.773~779 (2018)
  28. Chemaitilly W, "Diagnosis of endocrine disease : endocrine late-effects of childhood cancer and its treatments", Eur J Endocrinol, 176, pp.R183~R203 (2017)
  29. Rosene ML, "Inihibition of type 2 iodothyronine diodinase underlies the elevated plasma TSH associated with amiodarone treatment", Endocrinology, 151, pp.5961~5970 (2010)
  30. Tomer Y, "Interferon induced thyroiditis", Best Pract Res Clin Endocrinol Metab, 23, pp.703~712 (2009)
  31. Benedetti MS, "Alteration of thyroid hormone homeostasis by antiepileptic drugs in humans : involvement of glucuronosyltransferase induction", Eur J Clin Phamacol, 61, pp.863~872 (2005)
  32. Van den Berghe G, "Non-thyroidal illness in the ICU : a syndrome with different faces", Thyroid, 24, pp.1456~1465 (2014)
  33. Marks SD, "Nonthyroidal illness syndrome in children", Endocrine, 36, pp.355~367 (2009)
  34. Stockigt J, "Assessment of thyroid function : towards an integrated laboratory--clinical approach", Clin Biochem Rev, 24, pp.109~122 (2003)
  35. Favresse J, "Interferences with thyroid function immunoassays : clinical implications and detection algorithm", Endocr Rev, 39, pp.830~850 (2018)
  36. Hattori N, "Anti-thyrotropin autoantibodies in patients with macrothyrotropin and long-term changes in macro-thyrotropin and serum thyrotropin levels", Thyroid, 27, pp.138~146 (2017)
  37. Roelfsema F, "Thyrotropin secretion patterns in health and disease", Endocr Rev, 34, pp.619~657 (2013)
  38. Scobbo RR, "Serum TSH variability in normal individuals : the influence of time of sample collection", W V Med J, 100, pp.138~142 (2004)
  39. Benvenga S, "Serum thyrotropin and phase of the menstrual cycle", Front Endocrinol (Lausanne), 29(8), pp.250~ (2017)
  40. Gary KA, "Total sleep deprivation and the thyroid axis : effects of sleep and waking activity", Aviat Space Environ Med, 67, pp.513~519 (1996)
  41. Chaudhary V, "Thyroid ultrasound", Indian J Endocrinol Metab, 17, pp.219~227 (2013)
  42. Bauer AJ, "Evaluation and management of thyroid nodules in children", Curr Opin Pediatr, 28, pp.536~544 (2016)
  43. Ittermann T, "Serum thyroid stimulating hormone levels are associated with blood pressure in children and adolescents", Clin Endocrinol Metab, 97, pp.828~823 (2012)
  44. Çatlı G, "The effect of L thyroxine treatment on left ventricular functions in children with subclinical hypothyroidism", Arch Dis Child, 100, pp.130~137 (2015)
  45. Tacito LHB, "Impaired flowmediated dilation response and carotid intima-media thickness in patients with type 1 diabetes mellitus with a mean disease duration of 4. 1 years", Arch Endocrinol Metab, 61, pp.542~549 (2017)
  46. Bachar GN, "Epicardial adipose tissue as a predictor of coronary artery disease in asymptomatic subjects", Am J Cardiol, 110, pp.534~553 (2012)
  47. Farghaly HS, "Epicardial fat thickness in children with subclinical hypothyroidism and its relationship to subclinical atherosclerosis : a pilot study", Horm Res Paediatr, 92, pp.99~105 (2019)
  48. Cerbone M, "Cardiovascular risk factors in children with long-standing untreated idiopathic subclinical hypothyroidism", J Clin Endocrinol Metab, 99, pp.2697~2703 (2014)
  49. Cerbone M, "Linear growth and intellectual outcome in children with long-term idiopathic subclinical hypothyroidism", Eur J Endocrinol, 164, pp.591~597 (2011)
  50. Fiore E, "L-thyroxine-treated patients with nodular goiter have lower serum TSH and lower frequency of papillary thyroid cancer : results of a cross sectional study on 27, 914 patients", Endocr Relat Cancer, 17, pp.231~239 (2010)

관련 논문AI추천

Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses고대균, 박소현, 서병규, 정민호, 조경선, 조민선대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2014 · 제19권 제3호Screening and management of thyroid dysfunction in preterm infantsHye Rim Chung대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2019 · 제24권 제1호Predictors of transient congenital hypothyroidism in children with eutopic thyroid gland박일순, 소철환, 윤종서, 이혜상, 황진순대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2017 · 제22권 제2호Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort studyBalomenou Foteini, Baltogianni Maria, Deligeorgopoulou Marianna, Dermitzaki Niki, Giapros Vasileios, Kotanidou Eleni, Serbis Anastasios, Tsinopoulou Vasiliki Rengina대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2025 · 제30권 제3호Comparison between transient and permanent congenital hypothyroidism on a thyroid function test after re-evaluation김찬종, 양은미, Lee Hyun Gyung, Lee Song Han대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2023 · 제28권 제4호Follow-up of infants with congenital hypothyroidism and low total thyroxine/thyroid stimulating hormone on newborn screenLeslie Pitts, Quinn McCormick, Zachary Hughes대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2019 · 제24권 제4호

이 간행물의 다른 논문 (11건)

Commentary on "Haemostatic state in children with type 1 diabetes"Cho Won Kyungpp. 71-71Islet cell transplantation transitioning to proven therapy for type 1 diabetesKim Se Youngpp. 72-73Patients with disorders of sex developmentMarkosyan Renatapp. 74-79Pancreas transplant in type 1 diabetes mellitus: the emerging role of islet cell transplantJain Rakhi, Kochar Inderpal Singhpp. 86-91Vitamin D insufficiency and its contributing factors in primary school-aged children in Indonesia, a sun-rich countryPulungan Aman, Batubara Jose, Tridjaja Bambang, Soesanti Fridapp. 92-98
원문 보기