Prospective study of thyroid function in the first year of life in infants with Down syndrome.
Eur J Pediatr
; 182(6): 2903-2911, 2023 Jun.
Article
en En
| MEDLINE
| ID: mdl-37059961
ABSTRACT
Current American Academy of Pediatrics (AAP) Guidelines recommend monitoring thyroid function in infants with Down syndrome (DS) at birth, 6 and 12 months, and annually thereafter. This study aimed to determine whether these guidelines are optimal for early diagnosis and treatment of (subclinical) hypothyroidism. Enrolled infants with DS less than age 7 months, born at ≥ 30 weeks gestation to monitor thyroid function test (TFT). A filter paper (FP) blood sample was analyzed for TSH and total T4 at ages 2 and 4 weeks and monthly thereafter until 12 months. Subjects with abnormal FP sample and confirmatory serum TFT for hypothyroidism promptly started treatment. Subjects with thyroid dysfunction identified had thyroid antibodies measured at diagnosis and 12 months. Descriptive statistics determined average time to diagnosis of abnormal TFT. Sixteen (30%) of 54 subjects were diagnosed with a thyroid disorder, the majority with subclinical hypothyroidism (SH) and 1 with hyperthyroidism. Diagnosis occurred in 6 (11%), 9 (17%), and 12 (22.2%) infants in the first 30, 60, and 90 days of life (DOL), respectively. Eight infants had an abnormal NBS and half were diagnosed with a thyroid disorder by DOL 8 and the remainder prior to 4 months. Among subjects with a normal NBS, four were diagnosed at a mean of 104 days and three at a mean of 101 days prior to the 6-month and 12-month routine screens, respectively. Conclusion:
Based on current AAP guidelines, thyroid disorder diagnosis would have been delayed in nearly 20% of the subjects. An additional TFT screen at 1 and 3 months can lead to earlier diagnosis and treatment. What is Known ⢠Current American Academy of Pediatrics (AAP) Guidelines recommend thyroid function tests (TFT) in infants with Down syndrome (DS) at birth and 6 and 12 months. ⢠Peer- reviewed retrospective studies report an increased incidence of hypothyroidism in infants with DS undetected by the newborn screen (NBS) and prior to 6 months. What is New ⢠This prospective study monitored TFT in infants with DS at age 2 weeks and monthly throughout the first year of life. ⢠The findings in this study support additional TFT screens at 1 and 3 months in infants with DS.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades de la Tiroides
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Síndrome de Down
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Hipotiroidismo Congénito
/
Hipotiroidismo
Tipo de estudio:
Diagnostic_studies
/
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Child
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
Eur J Pediatr
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos