TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis.
BACKGROUND
Patients with Down syndrome (DS) often have elevated TSH (hypothalamic origin), which is called TSH neurosecretory dysfunction (TSH-nd). In these cases, there is slight elevation in TSH (5-15 µUI/mL), with normal free T4 and negative thyroid antibodies (AB).


OBJECTIVE
To recognize the risk of progression to Hashimoto's thyroiditis (HT).


METHODS
We retrospectively analyzed 40 DS patients (mean age = 4.5 years), followed up for 6.8 years.


RESULTS
HT was diagnosed in 9/40 patients, three early in monitoring, and six during evolution. In 31/40 patients, TSH-nd diagnosis remained unchanged over the years, with maximum TSH values ranging from 5 to 15 µUI/mL. In this group, free T4 also remained normal and AB were negative. There was a significant TSH reduction (p = 0.017), and normal TSH concentrations (< 5.0 µUI/mL) were observed in 29/31 patients, in at least one moment. No patient had TSH > 15 µUI/mL.


CONCLUSIONS
DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males).
Pediatric Endocrinology Unit, Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil. ceclau@terra.com.br
Claudia Dutra Costantin
CD
Faria
Simone
S
Ribeiro
Cristiane
C
Kochi
Aryane Pereira Neves da
AP
Silva
Bruna Natalia Freire
BN
Ribeiro
Lilian Teixeira
LT
Marçal
Felipe Henrique Yyazawa
FH
Santos
Calliari Procópio Luis
CP
Eduardo
Osmar
O
Monte
Carlos Alberto
CA
Longui
D000886:Anthropometry; D001323:Autoantibodies / Q000097:blood*; D002675:Child, Preschool; D018450:Disease Progression; D004314:Down Syndrome / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D050031:Hashimoto Disease / Q000209:etiology*; D006801:Humans; D008297:Male; D009489:Neurosecretion / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism*; D013974:Thyroxine / Q000097:blood*
D001323:Autoantibodies; D013972:Thyrotropin; D013974:Thyroxine