Thyroid Disorders In Children Research Articles

SARS-CoV-2 infection and thyroid dysfunction in children

The problem of thyroid dysfunction related to SARS-CoV-2 infection remains unclear in children. Therefore, the study aimed to reveal the interrelationship between thyroid dysfunction and COVID-19 severity­ as well as to determine optimal cut-off values for screening for thyroid disorders in children. A total number of 90 children aged from 1 month to 17 years were involved in the study. Patients with known thyroid disease were not recruited for the research. A thyroid panel was assessed for all participants that included: free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase (ATPO) antibodies. Statistical analysis was done using the computer software Statistica 13.0. Research has revealed euthyroid sick syndrome (ESS) in 14.10% of SARS-CoV-2 infected children more often among patients with severe COVID-19 and multisystem inflammatory syndrome (33.33%) compared to mild COVID-19 course (6.67%) and moderate disease severity (8.89%) (P < 0.05). Significant correlation relationships were revealed for next values – FT3 and erythrocyte sedimentation rate (ESR) (rs = -0.22; P < 0.05); FT3 and C-reactive protein (CRP) (rs = -0.33; P < 0.05); FT3 and procalcitonin (rs = -0.43; P < 0.05). The next cut-off values for ESS determination were revealed: ESR 18.5 mm/h (AUC 0.803); CRP 11.5 mg/l (AUC 0.763); ferritin 84.8 ng/ml (AUC 0.733). Results suggest that pediatricians should pay attention to the endocrine disruptions by COVID-19 in children. Keywords: COVID-19, euthyroid sick syndrome in children, inflammatory markers

Thyroid Disorders Spectrum in Pediatric Endocrine Clinic; Seven-Year Experience of a Teaching Hospital in Saudi Arabia.

Thyroid disorders constitute one of the major endocrine disorders in pediatric service. It includes a range of congenital versus acquired anatomic and/or functional thyroid diseases in growing children that has a spectrum of severity from severe intellectual disability effect to subclinical mild pathologies. This study was designed to analyze the demographic characteristics, clinical pattern, and severity of thyroid disorders in the pediatric endocrine clinic patients at the teaching hospital of the university over a 7-year duration. A total number of 148 patients with thyroid disorders were seen in pediatric Endocrine clinic during the time between January 2015 and December 2021. Female patients constitute 64% of them. Acquired Hypothyroidism was the commonest disorder; 34% of the cases followed by the congenital hypothyroidism (CH), then Hashimoto's thyroiditis, and 5.8% for others. While a very small percentage was acquired hyperthyroidism. The majority of referrals were from dermatology and other service for the screening of thyroid disease as association with other autoimmune diseases with percentage of 28.3%. Next was neck swelling manifestation in 22.6%. Thyroid disorders in children, both congenital and acquired, constitute an important medical issue for pediatricians to be aware of its variable presentations, and its potential serious health consequences on the affected children if not diagnosed and treated earlier. Acquired hypothyroidism constitutes more percentage of the thyroid disorders followed in the pediatric endocrinology outpatient clinics. Congenital hypothyroidism is the second most common thyroid disorder in the outpatient unit, having the most potential complications. These results support the international studies with the female predominance in most of thyroid disorders.

LONG-TERM THYROID DISORDERS IN CHILDREN RECEIVING ONCOLOGIC TREATMENT AND RADIOTHERAPY.

Childhood cancer survival has increased substantially over the past few decades. However, long-term side effects associated with cancer treatment have also risen. Especially thyroid gland disorders are common. The present retrospective cross-sectional study aimed to investigate risk factors of long-term TD in survivors of leukemia-lymphoma. The study included 44 acute lymphoblastic leukemia (ALL) and 26 Hodgkin lymphoma survivors (HL). Abnormal laboratory and pathological ultrasonographic findings of the thyroid gland were accepted as a thyroid disorder. The possible causes of thyroid disorders were investigated. Long-term thyroid disorder was found in 40% of the patients. This rate was higher in HL patients than in ALL (65% vs. 25%). Thyroid disorder was significantly more common in patients who received radiotherapy to the neck (57% vs. 17%). Radiotherapy to the neck area was the only significant determinant for thyroid disorders in the regression models [OR 33.17, 95% CI (2.76-398.9) p = 0.006]. However, HL remained significantly associated with TD in the logistic model performed using cancer type [OR 19.25, 95% CI (2.39-155.3) p = 0.006]. The study showed that radiotherapy applied to the neck was an essential risk factor for long-term TD in the average 6-year follow-up of cancer survivors. However, we recommend that childhood cancer survivors should be followed closely for a long time since long-term endocrine side effects were reported during longer than six years follow-up periods.

The influence of thyroid pathology on the course of periodontal disease in children and ways to correct it (Review)

Iodine deficiency diseases constitute an important medical and social problem, since a significant part of the territory of Ukraine is characterized by biogeochemical indicators of low iodine content in the environment, which is the cause of hypothyroidism development. At the same time, there are many other factors that can trigger the thyroid disorders in children. Epidemiological studies carried out in the Carpathian region have shown that iodine deficiency of varying degrees is specific to this area. Professor M.M. Kovalev's in-depth study of the causes of goitre in Bukovyna showed that along with iodine deficiency, macro- and micronutrient deficiencies associated with certain regions play an important role. Iodine deficiency promotes goitrogenesis and decreases the secretory capacity of the thyroid gland. As a result of reduced intrathyroid iodine in the gland, diiodothyrosine synthesis decreases and monoiodothyrosine increases, the hormone ratio increases due to an increase in the more biologically active triiodothyronine. This compensates for the euthyroid state against the background iodine deficiency. An adaptive manifestation of iodine deficiency is goitre, considered being the main sign of iodine deficiency; as iodine deficiency or thyroid hormone requirements increase, goiter size increases and more severe forms of thyroopathology develop. Iodine deficiency is common in many countries of the world. The analysis of the research data has shown the multifactorial nature of the etiology and pathogenesis of periodontal diseases in children, as well as the significant impact of thyroid disorders on the condition of the human dentition. In this regard, the study of cause-effect relationships between the initial manifestations of thyroid pathology and periodontal tissue changes in children seems relevant and promising in terms of improving methods of diagnosis, prevention and treatment. Keywords: periodontium, diffuse non-toxic goitre, children.

Frequency of Thyroid Dysfunction and Congenital Heart Defects in Subjects with Down Syndrome

ABSTRACT:
 Background: Down syndrome (DS) is the most common chromosomal abnormality with prevalence of 1 in 700-1500 live births. Its manifestations may include congenital heart defects(CHD), thyroid dysfunctions, hematopoietic disorders, early-onset Alzheimer disease, gastrointestinal disorders, neuromuscular weakness, hearing and visual problems, characteristic facial and physical features. The prevalence of thyroid disorders and congenital heart diseases are higher in DS patients than in general population.
 Objective:To explore the frequency, and types of congenital heart defects (CHD) and Thyroid disorders in children with Down syndrome (DS) in the children hospital and the institute of child health (CHICH) Multan.
 Study design: Descriptive cross sectional
 Setting: Outpatient department (OPD) of CHICH Multan
 Method:A total of 158 down syndrome (DS) patients of 0 to 15 years of age, of both genders were included in this study from October 2019 to October 2020. DS was diagnosed by specific clinical features and karyotyping. Age, sex and mother’s age was noted. Blood samples of all the patients were sent for karyotyping and serum T4 and Thyroid stimulation hormone (TSH). For patients more than 36 months, blood samples were also sent for Antithyroglobulin and antithyroid peroxidase antibodies. Echocardiography of all the patients was done. Data was collected and analyzed by using SPSS version 16.0.
 Results:Out of 158 DS children most presented below 6months of age, with male to female ratio of 1:1.4. Mostly mothers were between 20 to 40 years of age. Karyotyping revealed non disjunction in 97% of cases. Cardiac abnormalities were found in 48% of DS children. Most common Type was VSD (10.9%), Thyroid abnormalities were detected in 24% of DS patients, subclinical hypothyroidism (13.9%) was most common.
 Conclusion: CHD and Thyroid disorders must be ruled out in all DS patients,to start early management.
 Keywords: Down syndrome, Congenital heart disease, hypothyroidism.

A Study of Clinical Profile of Thyroid Disorders in Children in A Tertiary Care Hospital, Kurnool

Background: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation, so we want to determine the prevalence of thyroid dysfunction in children at kurnool district. Materials and Methods: A hospital based prospective observational study performed in new born and children below 18 years fulfilling the inclusion criteria visiting the pediatric OPD and IPD in Viswabharathi medical college, Kurnool if they had clinical suspicion of thyroid dysfunction. If suspicion of hypothyroidism, Free T4, Total T4, TSH levels and if suspicion of hyperthyroidism Free T3 and TSH were done. Results: Out of 70 case 3 cases (4.3%) are hyperthyroidism and 67 cases (95.7%) are hypothyroidism in these 3 (4.3%) cases had family history of thyroid disorders, male to female ratio was 1.3:6 and prevalence rate was high in the age group of 10 - 12 years 32.9% (23 cases). 13 (18.6%) cases had thyroid enlargement and 48 (68.57%) cases had anaemia. Treatment was started according to standard guidelines. Conclusion: The higher prevalence rate of thyroid disorders in childhood that to in female children and age group of 10 - 12 years in and around kurnool. Hence, screening of all new-borns and children should be mandatory as early diagnosis and treatment helps in prevention of complications of thyroid disorders. KEY WORDS: Free T3, Free T4, Goiter, Hyperthyroidism, Hypothyroidism, and Thyroid stimulating hormone.

Thyroid disorders in children and adolescents: Systematic mapping of global research over the past three decades

Background: Several countries research thyroid problems in children and adolescents. However, a scientometric assessment of global research in this field is unavailable. Aim: We aimed to provide a comprehensive assessment of research in thyroid disorders in children during 1990–2019. Methods: The data on pediatric thyroid disorders (PTDs) publications were retrieved from the Scopus database and analyzed using select bibliometric tools. Results: There were 4658 publications over the 30-year period registering an average annual and 15-year cumulative growth of 6.9% and 149.4%, respectively, and averaging 24.0 citations per paper. Of the 144 participating countries, the top ten contributed 69.9% of the global share. The most productive countries were the USA, Italy, and UK, whereas Netherlands, Canada, and the USA were the most impactful. Of the 745 participating organizations and 1275 authors, the top 20 of each contributed 26.2% and 7.9% of publication share, and 42.8% and 14.6% of citation share, respectively. The top three most productive organizations were INSERM, France, National Institute of Health, USA, and National Cancer Research Institute, USA, whereas the top three most productive authors were S. Yamashita, L. Persani, and G. Weber. Journal of Clinical Endocrinology and Metabolism, Journal of Pediatric Endocrinology and Metabolism, and Thyroid were the journals that published most research in PTDs. Conclusions: There is a substantial recent increase in the quantity of research on PTDs dominated by the North-American and Western-European countries. The vast disparities in pediatric thyroid research between high- and low-income countries need to be addressed through collaborations.

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

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.

A Cross-Sectional Study to Assess Thyroid Function in Infants and Children in a City from South-Western Romania.

Thyroid hormones are critical regulators of growth, myelination of the nervous system, metabolism, and organ function. The most prevalent endocrinopathies in childhood are related to thyroid disorders. Thyroid problems in children and adolescents have a significantly different etiology and clinical presentation than in adults. Thus, pediatric medical care involves an understanding of the unique features of thyroid function and dysfunction during childhood and adolescence. The etiology and clinical manifestations of thyroid disorders in children and adolescents are vastly different from those in adults. The particular aspects of thyroid function and malfunction in childhood and adolescence are hence part of pediatric medical therapy. To prevent persistent nervous system damage and developmental problems, it is vital to recognize and treat thyroid dysfunction in neonates as early as possible. The purpose of the research was to understand more how children's thyroid problems function, structure, and prevalence. The research examined 30 children under the age of 16 years who had symptoms that were linked to thyroid problems. In addition to demographic and family information, thyroid ultrasounds and blood samples for the detection of T3, T4, and TSH were obtained. Females surpassed males by a small majority (2.33:1 ratio).Out of the total children included in the study, 14(46.7%) cases for autoimmune thyroiditis, 2(6.67%) cases for congenital hypothyroidism, 1(3.33%) case for hyperthyroidism, 1(3.33%) case for hyperthyroidism-Graves disease, 8(26.7%) cases for hypothyroidism and 4(13.3%) cases for subclinical hypothyroidism.

Evaluation of the thyroid disorders in children with familial Mediterranean fever.

Although it is well-known that autoimmune thyroid diseases are more common in most of the autoimmune connective tissue diseases, the relationship between autoinflammatory diseases and autoimmune thyroid diseases has not well-evaluated yet and still remains unclear. The aim of this study was to investigate the frequency of autoimmune diseases of the thyroid gland and to evaluate thyroid function tests in children with familial Mediterranean fever. Thyroxine, thyroid-stimulating hormone, and thyroid autoimmune markers such as thyroid peroxidase and thyroglobulin antibodies, and thyroid ultrasound findings of 133 patients with familial Mediterranean fever and 70 healthy controls were evaluated. Serum levels of thyroid-stimulating hormone, free thyroxine, and thyroid autoimmunity markers were similar in patients with familial Mediterranean fever compared with healthy controls. There was no relationship between the duration of the disease and thyroid-stimulating hormone, free thyroxine, anti-thyroid peroxidase, and anti-thyroglobulin levels. This study revealed that incidence of thyroid dysfunction and autoimmunity is not increased in patients with familial Mediterranean fever. In conclusion, routine screening of serum thyroid function tests and thyroid antibody levels is not required in patients with familial Mediterranean fever in the absence of clinical symptoms or family history. Key Points • It is well-known that autoimmune thyroid diseases are common in autoimmune diseases. • The relationship between autoimmune thyroid diseases and autoinflammatory diseases like familial Mediterranean fever is still unclear. • In this study, we report the similar frequency of the autoinflammatory thyroid diseases in patients with familial Mediterranean fever and healthy controls. • A routine screening of serum thyroid function tests and thyroid antibody levels may not be required in patients with familial Mediterranean fever in the absence of clinical symptoms or family history.

Timing, prevalence, and dynamics of thyroid disorders in children and adolescents affected with Down syndrome.

Objectives Limited data on the evolution of thyroid disorders (TD) in Down syndrome (DS) are available. We characterized the timing, prevalence, and dynamics of TD in patients with DS during a long-term follow-up. Methods We retrospectively evaluated 91 children and adolescents with DS (12.5±8.3; follow-up 7.5±6.2). Children were monitored at birth, 6, and 12months of age and twice a year thereafter. Thyroid status and autoimmunity were periodically investigated. Results TD were detected in 73.6% of patients, in particular congenital hypothyroidism (CH), autoimmune thyroid diseases (ATD) and subclinical hypothyroidism (SH) were recorded in 16.4, 31.8, and 25.3%, respectively. CH was diagnosed at newborn screening in 86.7% of cases and in the first 6months of life in the remaining 13.3%; the condition was persistent in 61.5% of patients. In more than 30% of CH cases, glandular hypoplasia was also revealed. In the ATD group, 63.1% of patients with Hashimoto's disease (HD, 82.6%) were treated with levothyroxine and subjects with Graves' Disease (GD, 17.4%) started therapy with methimazole. DS with SH were treated in 42.1% of cases. A thyroid hypogenic echopattern, without autoantibody positivity was identified in 27.6% of SH patients. Conclusions The high prevalence and evolution of TD in SD requires frequent monitoring starting in the first months of life. CH can be misdiagnosed at screening. In DS subjects, there is a high prevalence of ATD and non-autoimmune diseases with early antibody-negative phases should not be excluded.

Etiology of thyroid disorders in children: A cross sectional study in a tertiary care centre

Etiology of thyroid disorders in children: A cross sectional study in a tertiary care centre - IJMPO- Print ISSN No: - 2581-4699 Online ISSN No:- 2581-4702 Article DOI No:- 10.18231/j.ijmpo.2019.027, IP International Journal of Medical Paediatrics and Oncology-IP Int J Med Paediatr Oncol

Clinical profile and etiology of thyroid disorders in children at a tertiary care hospital

Clinical profile and etiology of thyroid disorders in children at a tertiary care hospital

A Study to Determine Prevalance of Thyroid Disorders in Children and Adolescents with Vitiligo

A Study to Determine Prevalance of Thyroid Disorders in Children and Adolescents with Vitiligo

Pattern of Thyroid Disorders in Children and Adolescents Seen at the Lagos University Teaching Hospital, Nigeria, Over a 10-year Period.

Introduction:Thyroid disorders account for a large proportion of pediatric endocrine disorders. Untreated hypothyroidism in childhood has permanent adverse effects on physical, intellectual, and neurological development. However, few studies have reported the pattern of pediatric thyroid disorders in Nigeria.Objectives:The objective of this study was to document the pattern of thyroid disorders in children and adolescents seen at the Lagos University Teaching Hospital (LUTH) over a 10-year period.Participants and Methods:This is a retrospective descriptive study involving children with thyroid disorders seen from January 1, 2006 to December 31, 2015.Results:Seventy-one patients with thyroid disorders (0.13%) were seen out of 52,800 new cases (incidence of 1/1000 new cases) comprising 13.4% of 546 pediatric endocrine cases with a male:female ratio of 1:1.2. Median (range) age at presentation was 1.6 (0.001–14) years. Congenital hypothyroidism (CH) constituted a major proportion of cases (46.7%), with a median (range) age at presentation of 9 (1.5–24) months. Down syndrome constituted 45% of patients with CH with associated congenital heart defects in eight (53%) patients. Acquired hypothyroidism was seen in ten patients (five goitrous and five nongoitrous). Six patients had hypothyroidism associated with multiple anterior pituitary hormone deficiency. Nine patients (all females) had hyperthyroidism with confirmed Graves' disease in 5 (55.6%), with mean age at presentation being 9.4 ± 2.09 years. Other conditions were euthyroid sick syndrome (2.8%), euthyroid goiter (1.4%), and acute thyroiditis (1.4%). Eight infants of mothers on treatment for hyperthyroidism ( first seen between the 7th h of life to 2 months of age) had transient hypothyroidism while one 8-day-old had transient hyperthyroidism.Conclusion:CH was the most common disorder encountered with late age at presentation. Routine newborn screening and maintaining a high index of suspicion are advocated.

Thyroid Disorders in Children and Adolescents: A Review.

Normal thyroid gland function is critical for early neurocognitive development, as well as for growth and development throughout childhood and adolescence. Thyroid disorders are common, and attention to physical examination findings, combined with selected laboratory and radiologic tools, aids in the early diagnosis and treatment. To provide a practical review of the presentation, evaluation, and treatment of thyroid disorders commonly encountered in a primary care practice. We performed a literature review using the PubMed database. Results focused on reviews and articles published from January 1, 2010, through December 31, 2015. Articles published earlier than 2010 were included when appropriate for historical perspective. Our review emphasized evidence-based management practices for the clinician, as well as consensus statements and guidelines. A total of 479 articles for critical review were selected based on their relevance to the incidence, pathophysiology, laboratory evaluation, radiological assessment, and treatment of hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer in children and adolescents. Eighty-three publications were selected for inclusion in this article based on their relevance to these topics. The primary care physician is often the first health care professional responsible for initiating the evaluation of a thyroid disorder in children and adolescents. Patients may be referred secondary to an abnormal newborn screening, self-referred after a caregiver raises concern, or identified to be at risk of a thyroid disorder based on findings from a routine well-child visit. Irrespective of the path of referral, knowledge of the signs and symptoms of hypothyroidism, hyperthyroidism, and thyroid nodules, as well as the general approach to evaluation and management, will help the primary care physician complete an initial assessment and determine which patients would benefit from referral to a pediatric endocrinologist. Early identification and treatment of thyroid disease in children and adolescents is critical to optimize growth and development. The primary care physician plays a critical role in identifying patients at risk. An understanding of risk factors, clinical signs and symptoms, and interpretation of screening laboratories ensures an efficient and accurate diagnosis of these common disorders. Regular communication between the primary care physician and the subspecialist is critical to optimize outcome because the majority of patients with thyroid disorders will require long-term to lifelong medical therapy and/or surveillance.

A Review of Thyroid Disorders in Children

Pediatric practitioners must consider the possibility of thyroid disorders as they evaluate their patients. Investigators have now provided a concise

Thyroid dysfunction in children and adolescence: Experience of a tertiary care centre in Kerala

Background: There is limited data regarding the prevalence of thyroid disorders in children and adolescents from India. Methods: All subjects aged 1-19 years, who underwent estimation of thyroid function tests (TFTs) at the EMS Memorial Cooperative Hospital and Research Centre, Perinthalmanna (2009-2013) were included in the study. Results: A total of 784 subjects (males-336, females-448), aged between 1-19 (Mean 11.12, SD-6.23) years, who under-went estimation of TFTs were studied. The prevalence rate of all thyroid function abnormalities was 9.18%. The thyroid function disorders were more common (10.89%) in adolescents (14-19 years) than children (1-13 years) (7.82%) and in females (12.05%) than males (5.36%) in both age groups. The prevalence rates of subclinical hypothyroidism (SCH), overt hypothyroidism (OH) and hyperthyroidism were 4.08%, 3.05% and 2.04% respectively. Conclusions: The thyroid function abnormalities are common in children and adolescents affecting about ~ 9% in study population. The SCH was the commonest thyroid function disorder, followed by OH and hyperthyroidism with female: male ratios of 2.5:1, 2.43:1 and 7:1 respectively. Majority of cases OH were of primary hypothyroidism. The SCH and hyperthyroidism were more prevalent in the adolescents than children; however, OH was more common in children than adolescents.

Incidence and etiology of thyroid disorders in children

Incidence and etiology of thyroid disorders in children

Thyroid Disorders in Children

Thyroid Disorders in Children