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

Valeria Calcaterra, Erica Crivicich, Annalisa De Silvestri, Rossella Amariti, Andrea Martina Clemente, Francesco Bassanese, Corrado Regalbuto, Federica Vinci, Riccardo Albertini, Daniela Larizza

Research output: Contribution to journalArticlepeer-review

Abstract

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 12 months 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 6 months 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.

Original languageEnglish
Pages (from-to)885-891
Number of pages7
JournalJournal of pediatric endocrinology & metabolism : JPEM
Volume33
Issue number7
DOIs
Publication statusPublished - Jul 28 2020

Keywords

  • adolescents
  • children
  • Down syndrome
  • hypothyroidism

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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