Does clinical management impact height potential in children with severe acquired hypothyroidism?
BACKGROUND
Severe acquired hypothyroidism often results in significant height deficit due to rapid bone age advancement following treatment. Whether gradual correction of hypothyroidism and/or adjunctive growth-promoting therapies (GPTs) augment final adult height (FAH) is controversial.


OBJECTIVE
To investigate time to euthyroidism, pace of bone age advancement (deltaBA/deltaCA), and impact of GPTs on FAH.


METHODS
Retrospective review of 21 children (10.1 +/- 3.0 years) with profound hypothyroidism.


RESULTS
Baseline bone age standard deviation score (SDS) was -4.1 +/- 1.8, whereas height SDS was -3.0 +/- 1.1. Average time to euthyroidism was 9.7 months (2.3-33.7 months). Average deltaBA/deltaCA was 2.3 +/- 0.9. Six of 13 patients at FAH received GPTs. No correlation was found between time to euthyroidism and rate of skeletal maturation. No difference in height outcome was seen between those who received GPTs and those who did not.


CONCLUSIONS
Neither time to euthyroidism nor use of GPTs significantly affected height potential in our patients.
Section of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA. tdnebesi@iupui.edu
Todd D
TD
Nebesio
Matthew D
MD
Wise
Susan M
SM
Perkins
Erica A
EA
Eugster
D000293:Adolescent; D001827:Body Height / Q000187:drug effects* / Q000502:physiology; D001846:Bone Development / Q000187:drug effects / Q000502:physiology; D002648:Child; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D004359:Drug Therapy, Combination; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013974:Thyroxine / Q000627:therapeutic use*
D019382:Human Growth Hormone; D013974:Thyroxine