Hashimoto’s Thyroiditis in Down’s Syndrome: Clinical Presentation and EvolutionPopova G.a · Paterson W.F.b · Brown A.c · Donaldson M.D.C.b
aUniversity Children’s Hospital, Sofia, Bulgaria; bDepartment of Child Health, and cScottish National Neonatal Screening Laboratory, Royal Hospital for Sick Children, Glasgow, UK
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Aim: It was the aim of this study to describe the presentation and clinical course of Hashimoto’s thyroiditis (HT) in children with Down’s syndrome (DS) in 2 Scottish health regions. Patients and Methods: We retrospectively analysed clinical, biochemical and thyroid antibody status in 38 patients with DS with HT diagnosed from 1989 to 2004. Results: The sex distribution was similar (20 males, 18 females), with a median age of 12.3 years (range 2.1–17.7). Of the 38 patients reviewed, 29 were identified by screening. A goitre was present in 6/38 patients. Thyroid antibodies were positive in 36/38 patients, negative in 1/38, and data were unavailable for 1/38. At presentation, 37/38 patients were hypothyroid: 21/37 with compensated hypothyroidism (6 treated initially) and 16/37 with decompensated hypothyroidism (all treated). Of the 15/21 compensated patients who were untreated initially, only 3 remitted while 12 showed disease progression prompting treatment. In the decompensated group, 1/16 patient pursued a fluctuating course between hypo- and hyperthyroidism. The final patient, who was hyperthyroid at presentation, also showed marked fluctuation in thyroid function over a 5-year period. Conclusion: The natural history of HT in DS is unusual, with no female predominance and infrequent goitre in our cohort. While almost all patients required treatment eventually, clinicians should be aware that the disease may pursue a fluctuating course between hypo- and hyperthyroidism.
© 2008 S. Karger AG, Basel
- Fort P, Lifshitz F, Bellisario R, Davis J, Lanes R, Pugliese M, Richman R, Post EM, David R: Abnormalities of thyroid function in infants with Down syndrome. J Pediatr 1984;104:545–549.
- Cutler AT, Benezra-Obeiter R, Brink SJ: Thyroid function in young children with Down syndrome. Am J Dis Child 1986;140:479–483.
- Oakley GA, Muir T, Ray M, Girdwood RWA, Kennedy R, Donaldson MDC: Increased incidence of congenital malformations in children with transient thyroid-stimulating hormone elevation on newborn screening. J Pediatr 1998;132:726–730.
Shalitin S, Phillip M: Autoimmune thyroiditis in infants with Down’s syndrome. J Pediatr Endocrinol 2002;15:649–652.
- Idris I, O’Malley BP: Thyrotoxicosis in Down’s and Turner’s syndromes: the likelihood of Hashimoto’s thyroiditis as the underlying aetiology. Int J Clin Pract 2000;54:272–273.
- Rudberg C, Johansson H, Akerstrom G, Tuvema T, Karlsson FA: Graves’ disease in children and adolescents. Late results of surgical treatment. Eur J Endocrinol 1996;134:710–715.
Prasher VP: Reliability of diagnosing clinical hypothyroidism in adults with Down syndrome. Aust NZ J Dev Disabil 1995;20:223–233.
DSMIG: Basic medical surveillance essentials for people with Down’s syndrome. Recommendations of the Down’s Syndrome Medical Interest Group, Thyroid Disorder. 2001. www.dsmig.org.uk.
- Noble SE, Leyland K, Findlay CA, Clark CE, Redfern J, Mackenzie JM, Girdwood RWA, Donaldson MDC: School based screening for hypothyroidism in Down’s syndrome by dried blood spot TSH measurement. Arch Dis Child 2000;82:27–31.
- Sharav T, Collins RM, Baab PJ: Growth studies in infants and children with Down’s syndrome and elevated levels of thyrotropin. Am J Dis Child 1988;142:1302–1306.
- Selikowitz M: A five-year longitudinal study of thyroid function in children with Down syndrome. Dev Med Child Neurol 1993;35:396–401.
- Marasco JA Jr, Feczko WA: Basal ganglia calcification in Down’s syndrome. Comput Tomogr 1979;3:111–113.
Lobo Ede H, Khan M, Tew J: Community study of hypothyroidism in Down’s syndrome. BMJ 1980;24:1253.
- Tuysuz B, Beker DB: Thyroid dysfunction in children with Down’s syndrome. Acta Paediatr 2001;90:1389–1393.
- Karlsson B, Gustafsson J, Hedov G, Ivarsson SA, Anneren G: Thyroid dysfunction in Down’s syndrome: relation to age and thyroid autoimmunity. Arch Dis Child 1998;79:242–245.
Fargas A, Martinez J, Dominguez P, Albert DC, Yeste D, Toran N: Thirteen month old girl with Down syndrome, pericardial effusion and hypothyroidism. Pediatria Catalana 1996;56:39–42.
- Zori RT, Schatz DA, Ostrer H, Williams CA, Spillar R, Riley WJ: Relationship of autoimmunity to thyroid dysfunction in children and adults with Down syndrome. Am J Med Genet Suppl 1990;7:238–241.
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