Spectrum of clinical presentation of thyroid disorders in children in a tertiary care teaching hospital: An observational study

Abstract

Introduction: Thyroid disorders during childhood are quite common and presentations are nonspecific. Congenital hypothyroidism (CH), among all causes of childhood hypothyroidism, is the most important, as early detection and appropriate therapy can prevent the onset of brain damage. The delay in diagnosis is attributable to the lack of awareness, lack of available facilities, or newborn screening programs. Aims: This study aims to study the spectrum of clinical presentation of thyroid disorders in children in a tertiary care teaching hospital. Materials and Methods: A descriptive observational study was conducted for a 2-year period, from January 2018 to January 2020. All children who were referred to the pediatric endocrine out-patients clinic for suspected thyroid dysfunction were included in this study. Data on patients history, clinical examination including the presence of goiter and laboratory tests were collected and analyzed. Results: Of 86 children with suspected thyroid dysfunction, 32 had abnormal thyroid function tests. Six had CH, 19 had overt acquired hypothyroidism and six had subclinical acquired hypothyroidism. Thyroid peroxidase antibodies were elevated in 13 children with no gender predilection. There was a female preponderance across all the age groups but no gender predilection was noted in the CH group. Short stature was noted in 70.9% of cases, diminution in school performance in 58% and pallor in 29%. Goiter was observed in 9.6% of children. Conclusions: In our study, 80.6% had acquired hypothyroidism. The most common presenting feature was short stature which was observed in 70.9% of our children. Diminution of scholastic performance was the second common clinical feature which was observed in 58% of children.