title: Prevalence and Determinants of True Thyroid Dysfunction Among Pediatric Referrals for Abnormal Thyroid Function Tests.
abstract: Background/Aims. Abnormalities in thyroid function tests (TFTs) are a common referral reason for pediatric endocrine evaluation. However, a sizable proportion of these laboratory abnormalities do not warrant therapy or endocrine follow-up. The objectives of this study were (a) to evaluate the prevalence of true thyroid dysfunction among pediatric endocrinology referrals for abnormal TFTs; (b) to identify the historical, clinical, and laboratory characteristics that predict decision to treat. Methods. This was a retrospective chart review of patients evaluated in pediatric endocrinology office during a weekly clinic designated for new referrals for abnormal TFTs in 2010. Results. A total of 230 patients were included in the study. Median age at referral was 12 years (range = 2-18); 56% were females. Routine screening was cited as the reason for performing TFTs by 33% patients. Majority was evaluated for hypothyroidism (n = 206). Elevated thyroid-stimulating hormone was the most common referral reason (n = 140). A total of 41 out of 206 patients were treated for hypothyroidism. Conclusions. Prevalence of hypothyroidism was 20%. Thyroid follow-up was not recommended for nearly one third of the patients. Among all the factors analyzed, an elevated thyroid-stimulating hormone level and antithyroglobulin antibodies strongly correlated with the decision to treat (P < .005).
authors.affiliation: Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Lahoti
authors.affiliation: Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Klein
authors.affiliation: Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Schumaker
authors.affiliation: Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Vuguin
authors.affiliation: Cohen Children's Medical Center, Northwell Health, Lake Success, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors.forename: Graeme
authors.initials: G
authors.lastname: Frank
keywords: endocrinology; hypothyroidism; referrals; thyroid dysfunction; thyroid function tests