TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis

• Autor(a) principal: Faria, Claudia Dutra Costantin
• Data de Publicação: 2011
• Outros Autores: Ribeiro, Simone, Kochi, Cristiane, Silva, Aryane Pereira Neves da, Ribeiro, Bruna Natalia Freire, Marçal, Lilian Teixeira, Santos, Felipe Henrique Yyazawa, Calliari, Luis Eduardo Procopio [UNIFESP], Monte, Osmar, Longui, Carlos Alberto
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000q9bh
• Texto Completo: http://dx.doi.org/10.1590/S0004-27302011000800018; http://repositorio.unifesp.br/handle/11600/42709
• topic: Down syndrome; Hashimoto's thyroiditis; TSH neurosecretory dysfunction; isolated TSH elevation

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