TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis
Introduction: 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 mu UI/mL), with normal free T4 and negative thyroid antibodies (AB). Objective: To recognize t...
| Autores: | , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2011 |
| País: | Brasil |
| Institución: | Universidade Federal de São Paulo (UNIFESP) |
| Repositorio: | Repositório Institucional da UNIFESP |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.unifesp.br:11600/42709 |
| Acceso en línea: | http://dx.doi.org/10.1590/S0004-27302011000800018 http://repositorio.unifesp.br/handle/11600/42709 |
| Access Level: | acceso abierto |
| Palabra clave: | Down syndrome Hashimoto's thyroiditis TSH neurosecretory dysfunction isolated TSH elevation |
| Sumario: | Introduction: 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 mu UI/mL), with normal free T4 and negative thyroid antibodies (AB). Objective: To recognize the risk of progression to Hashimoto's thyroiditis (HT). Subjects and 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 mu UI/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 mu UI/mL) were observed in 29/31 patients, in at least one moment. No patient had TSH > 15 mu UI/mL. Conclusion: DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males). Arq Bras Endocrinol Metab. 2011;55(8):628-31 |
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