Skip to main content
Top
Published in: Italian Journal of Pediatrics 1/2010

Open Access 01-12-2010 | Commentary

At the end of a two-year follow-up elevated TSH levels normalize or remain unchanged in most the children with subclinical hypothyroidism

Authors: Filippo De Luca, Malgorzata Wasniewska, Giuseppina Zirilli, Tommaso Aversa, Teresa Arrigo

Published in: Italian Journal of Pediatrics | Issue 1/2010

Login to get access

Abstract

Data about the natural evolution of subclinical hypothyroidism (SH) in pediatric age are very scanty. Moreover all the available reports in both aged and young patients were based on unselected study populations including also patients with either thyroid disorders or other pathological causes that are well known to be able to affect SH development and evolution. Aim of the study by Wasniewska et al was to prospectively evaluate for the first time the natural course of SH in children and adolescents with no underlying diseases and no risk factors that might interfere with the progression of SH. On the basis of the 2-year follow-up results, the Authors concluded that: a) the natural course of TSH values in a pediatric population with idiopathic SH is characterized by a progressive decrease over time; b) the majority of patients (88%) normalized or maintained unchanged their TSH; and c) TSH changes were not associated with changes of either FT4 values or clinical status or auxological parameters.
Study design of this study is very accurate and the results are robust, thus supporting the Authors' conclusions.
Literature
1.
go back to reference Wasniewska M, Salerno M, Cassio A, Corrias A, Aversa T, Zirilli G, Capalbo D, Bal M, Mussa A, De Luca G: Prostective evaluation of the natural corse of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol. 2009, 160: 417-421. 10.1530/EJE-08-0625.PubMedCrossRef Wasniewska M, Salerno M, Cassio A, Corrias A, Aversa T, Zirilli G, Capalbo D, Bal M, Mussa A, De Luca G: Prostective evaluation of the natural corse of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol. 2009, 160: 417-421. 10.1530/EJE-08-0625.PubMedCrossRef
2.
go back to reference Krude H: Thyroid in Yearbook of Pediatric Endocrinology 2009. Karger. Edited by: Carel JC, Hochberg Z. 2009, 37-38. Krude H: Thyroid in Yearbook of Pediatric Endocrinology 2009. Karger. Edited by: Carel JC, Hochberg Z. 2009, 37-38.
3.
go back to reference Mazzaferri EL: Elevated TSH levels normalize or remain unchanged in the majority of children with subclinical hypothyroidism. Clinical Thyroidology. 2009, 21: 11-13. Mazzaferri EL: Elevated TSH levels normalize or remain unchanged in the majority of children with subclinical hypothyroidism. Clinical Thyroidology. 2009, 21: 11-13.
4.
go back to reference Chu JW, Crapo LM: The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab. 2001, 86: 4591-4599. 10.1210/jc.86.10.4591.PubMedCrossRef Chu JW, Crapo LM: The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab. 2001, 86: 4591-4599. 10.1210/jc.86.10.4591.PubMedCrossRef
5.
go back to reference McDermott MT, Ringway EC: Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab. 2001, 86: 4585-4590. 10.1210/jc.86.10.4585.PubMedCrossRef McDermott MT, Ringway EC: Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab. 2001, 86: 4585-4590. 10.1210/jc.86.10.4585.PubMedCrossRef
6.
go back to reference Cetinkaya E, Aslan AT, Vidinlisan S, Ocal G: Height improvement by L-thyroxine treatment in subclinical hypothyroidism. Pediatr Int. 2003, 45: 534-537. 10.1046/j.1442-200X.2003.01786.x.PubMedCrossRef Cetinkaya E, Aslan AT, Vidinlisan S, Ocal G: Height improvement by L-thyroxine treatment in subclinical hypothyroidism. Pediatr Int. 2003, 45: 534-537. 10.1046/j.1442-200X.2003.01786.x.PubMedCrossRef
7.
go back to reference Paoli-Valari M, Mamàn-Alvarado D, Jimènez-Lòpez V, Arias-Ferreira A, Bianchi G, Arata-Ballabarba G: Frequency of subclinical hypothyroidism among healthy children and those with neurological conditions in the state of Mèrida. 2003, 44: 209-218. Paoli-Valari M, Mamàn-Alvarado D, Jimènez-Lòpez V, Arias-Ferreira A, Bianchi G, Arata-Ballabarba G: Frequency of subclinical hypothyroidism among healthy children and those with neurological conditions in the state of Mèrida. 2003, 44: 209-218.
8.
go back to reference Wu T, Flowers JW, Tudiver F, Wilson JL, Punyasavatsut N: Subclinical thyroid disorders and cognitive performance among adolescents in the United States. BMC Pediatr. 2006, 6: 12-10.1186/1471-2431-6-12.PubMedCentralPubMedCrossRef Wu T, Flowers JW, Tudiver F, Wilson JL, Punyasavatsut N: Subclinical thyroid disorders and cognitive performance among adolescents in the United States. BMC Pediatr. 2006, 6: 12-10.1186/1471-2431-6-12.PubMedCentralPubMedCrossRef
9.
go back to reference Cooper DS: Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001, 345: 260-25. 10.1056/NEJM200107263450406.PubMedCrossRef Cooper DS: Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001, 345: 260-25. 10.1056/NEJM200107263450406.PubMedCrossRef
10.
go back to reference Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S, Study Group for Thyroid Diseases of the Italian Society For pediatric Endocrinology and Diabetes (SIEDP/ISPED): The natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006, 149: 827-832. 10.1016/j.jpeds.2006.08.045.PubMedCrossRef Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S, Study Group for Thyroid Diseases of the Italian Society For pediatric Endocrinology and Diabetes (SIEDP/ISPED): The natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006, 149: 827-832. 10.1016/j.jpeds.2006.08.045.PubMedCrossRef
11.
go back to reference Moore DC: Natural course of "subclinical" hypothyroidism in childhood and adolescence. Arch Pediatr Adolesc Med. 1996, 150: 293-297.PubMedCrossRef Moore DC: Natural course of "subclinical" hypothyroidism in childhood and adolescence. Arch Pediatr Adolesc Med. 1996, 150: 293-297.PubMedCrossRef
12.
go back to reference Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, Mc Dermot MT: Subclinicl thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, The American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005, 90: 581-585. 10.1210/jc.2004-1231.PubMedCrossRef Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, Mc Dermot MT: Subclinicl thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, The American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005, 90: 581-585. 10.1210/jc.2004-1231.PubMedCrossRef
13.
go back to reference Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ: Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004, 291: 228-238. 10.1001/jama.291.2.228.PubMedCrossRef Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ: Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004, 291: 228-238. 10.1001/jama.291.2.228.PubMedCrossRef
14.
go back to reference American Association of Clinical Endocrinologists: American Association of Clinical Endcorinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002, 8: 457-469. American Association of Clinical Endocrinologists: American Association of Clinical Endcorinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002, 8: 457-469.
15.
go back to reference Arrigo T, Wasniewska M, Crisafulli G, Lombardo F, Messina MF, Rulli I, Salzano G, Valenzise M, Zirilli G, De Luca F: Subclinical hypothyroidism: The state of the art. J Endocrinol Invest. 2008, 31: 79-84.PubMedCrossRef Arrigo T, Wasniewska M, Crisafulli G, Lombardo F, Messina MF, Rulli I, Salzano G, Valenzise M, Zirilli G, De Luca F: Subclinical hypothyroidism: The state of the art. J Endocrinol Invest. 2008, 31: 79-84.PubMedCrossRef
Metadata
Title
At the end of a two-year follow-up elevated TSH levels normalize or remain unchanged in most the children with subclinical hypothyroidism
Authors
Filippo De Luca
Malgorzata Wasniewska
Giuseppina Zirilli
Tommaso Aversa
Teresa Arrigo
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2010
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/1824-7288-36-11

Other articles of this Issue 1/2010

Italian Journal of Pediatrics 1/2010 Go to the issue