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Thyroid Function Tests in Children and Adolescents With Trisomy 21: Definition of Syndrome-Specific Reference Ranges.
Cattoni, Alessandro; Molinari, Silvia; Capitoli, Giulia; Masera, Nicoletta; Nicolosi, Maria Laura; Barzaghi, Silvia; Marziali, Giulia; Lazzerotti, Alessandra; Gazzarri, Alessandra; Vimercati, Chiara; Sala, Debora; Biondi, Andrea; Galimberti, Stefania; Fossati, Chiara.
Afiliación
  • Cattoni A; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Molinari S; School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza (MB), Italy.
  • Capitoli G; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Masera N; B4 Center of Bioinformatics, Biostatistics e Bioimaging, University of Milano-Bicocca, 20854 Vedano al Lambro (MB), Italy.
  • Nicolosi ML; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Barzaghi S; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Marziali G; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Lazzerotti A; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Gazzarri A; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Vimercati C; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Sala D; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Biondi A; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Galimberti S; Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza (MB), Italy.
  • Fossati C; School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza (MB), Italy.
J Clin Endocrinol Metab ; 108(11): 2779-2788, 2023 10 18.
Article en En | MEDLINE | ID: mdl-37279507
CONTEXT: The lack of syndrome-specific reference ranges for thyroid function tests (TFT) among pediatric patients with Down syndrome (DS) results in an overestimation of the occurrence of hypothyroidism in this population. OBJECTIVE: To (a) outline the age-dependent distribution of TFT among pediatric patients with DS; (b) describe the intraindividual variability of TFT over time; and (c) assess the role of elevated thyrotropin (TSH) in predicting the future onset of overt hypothyroidism. METHODS: In this retrospective, monocentric, observational analysis, we included 548 patients with DS (0-18 years) longitudinally assessed between 1992 and 2022. Exclusion criteria were abnormal thyroid anatomy, treatments affecting TFT, and positive thyroid autoantibodies. RESULTS: We determined the age-dependent distribution of TSH, FT3, and FT4 and outlined the relative nomograms for children with DS. Compared with non-syndromic patients, median TSH levels were statistically greater at any age (P < .001). Median FT3 and FT4 levels were statistically lower than controls (P < .001) only in specific age classes (0-11 for FT3, 11-18 years for FT4). TSH levels showed a remarkable fluctuation over time, with a poor (23%-53%) agreement between the TSH centile classes at 2 sequential assessments. Finally, the 75th centile was the threshold above which TSH values predicted future evolution into overt hypothyroidism with the best statistical accuracy, with a satisfactory negative predictive value (0.91), but poor positive predictive value (0.15). CONCLUSION: By longitudinally assessing TFT in a wide pediatric DS population, we outlined the syndrome-specific reference nomograms for TSH, FT3, and FT4 and demonstrated a persistent upward shift of TSH compared to non-syndromic children.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Down / Hipotiroidismo Tipo de estudio: Prognostic_studies Límite: Adolescent / Child / Humans Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Down / Hipotiroidismo Tipo de estudio: Prognostic_studies Límite: Adolescent / Child / Humans Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos