Thyroid dysfunction in adults with Down's syndrome

Tharayil Suresh,Pauline Robertson

doi:10.1192/pb.17.8.477

Abstract

Thyroid treatment was used at the beginning of the 20th century for people with Down's syndrome, and an improvement in the physical and mental response was noted (Smith & Berg, 1976). Later studies reported conflicting findings about the prevalence and type of thyroid dysfunction (Sare et al, 1978; Lobo et al, 1980) but there now seems little doubt about the existence of a high prevalence of hypothyroidism (Mani, 1988; Dinani & Carpenter, 1990).

Highlights

T20htyhrociedntutrreyatmfoernpteowpales wusiethd Datotwhne'sbesgyinndnrionmg eo, fatnhde an improvement in the physical and mental response was noted (Smith & Berg, 1976)
At a meeting of the hospital's Medical Audit Com mittee, it was agreed that the therapeutic aim was tDoowacnh'sievsyenedurothmyero. iTdhisstawtuosuldinbealalssinesdsievdidfuraolms twheitihr biochemical thyroid function tests, using TSH and thyroxine levels
The time limits could be adjusted if necessary, e.g. if it were found that several new cases of hypo thyroidism occurred within the three year review period

Summary

The audit process

At a meeting of the hospital's Medical Audit Com mittee, it was agreed that the therapeutic aim was tDoowacnh'sievsyenedurothmyero. iTdhisstawtuosuldinbealalssinesdsievdidfuraolms twheitihr biochemical thyroid function tests, using TSH and thyroxine levels. ITdhisstawtuosuldinbealalssinesdsievdidfuraolms twheitihr biochemical thyroid function tests, using TSH and thyroxine levels. LishTihneg ftihrestesxtiesptinogf tthheyraouidditstactyucsleocfoDnsoiwstned's opfateiestnatbs, the second of adjusting their medication if necessary, and the third of repeating the thyroid function tests within the specified time limits and identifying any new or inadequately treated cases of thyroid dis order. The time limits could be adjusted if necessary, e.g. if it were found that several new cases of hypo thyroidism occurred within the three year review period. Forty-six subjects (33 male and 13 female) had thyroid function tests within normal limits. Eleven known and three new cases of hypothyroidism, with a raised TSH and low thyroxine level, were identified. Seven cases has raised TSH but normal thyroxine levels, coming into the category of sub-clinical hypothyroidism. There was one known case of hyperthyroidism and one new case of sub-clinical hyperthyroidism (normal TSH, raised thyroxine).

Establishment of a recall system

The study

Findings