Transient Hyperthyrotropinemia in Outpatient Children with Acute Infections of the Respiratory System.

Katarzyna Adamczewska,Zbigniew Adamczewski,Renata Stawerska,Magdalena Stasiak,Andrzej Lewiński

doi:10.3390/ijerph18084115

Abstract

Background: Diagnostics of thyroid disorders (TD) are frequently based on the measurements of thyroid stimulating hormone (TSH) concentration only. If TSH is outside the reference range, the diagnostic procedure used in patients with TD isintroduced. Observations indicate that in a considerable number of these patients, TD is not confirmed. The aim of the study was to assess the incidence of transient hyperthyrotropinemia in healthy children during acute infections of the respiratory system. Patients and Methods: The study included consecutive children (49 boys and 45 girls), aged 2.2–17.3 years, who visited one General Practitioner (GP) due to respiratory tract infections. The tests: complete blood count (CBC), C-reactive protein (CRP), TSH and FT4 were run on the next day after the visit at the physician’s (initial visit) and ≥2 weeks after recovery. Results: Among these children, elevated TSH values were found in about 10% of patients, and they went back to normal values after recovery. A prospective analysis showed a reduction of TSH values in approx. 65% of all groups and TSH at the follow-up visit was significantly lower. Conclusions: Transient hyperthyrotropinemia was observed in about 10% of children with acute respiratory tract infection. This preliminary finding remains unexplained.

Highlights

Normal thyroid hormone secretion and action are essential for both fetal and post-natal neurodevelopment
Elevated C-reactive protein (CRP) was observed in 31.9%, neutrophilia or elevated white blood cell (WBC) were found in 23.4%
In nine children from the studied group (9.6%), thyroid stimulating hormone (TSH) concentration values exceeded the upper limit of the normal range, but none of them exceeded 7.0 mIU/L

Summary

Introduction

Normal thyroid hormone (thyroxine-T4 and triiodothyronine-T3) secretion and action are essential for both fetal and post-natal neurodevelopment. It is important for, normal growth and metabolic processes in children [1,2]. In approximately 2% of children, subclinical hypothyroidism is present It can be defined as primary biochemically compensated hypothyroidism [1,2]. In these conditions, normal FT4 and free T3 (FT3) and elevated TSH serum concentrations are observed. A prospective analysis showed a reduction of TSH values in approx

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