Hipotiroidismo y síndrome de Down

Introduction

Subclinical hypothyroidism is common in the first years of life of children with Down's syndrome (DS). The aim of this study was to analyse the natural evolution of this disease and to identify the factors that predict its spontaneous remission.

Material and methods

A retrospective, observational study conducted on patients with DS and hypothyroidism diagnosed before 5 years of age, who were seen in a DS reference medical centre.

Results

A total of 53 patients, 28 boys and 25 girls, with a mean age 2.4 ± 1.1 years, were identified with subclinical hypothyroidism. The hypothyroidism resolve spontaneously in 39 cases (73.6%), in a mean time of 13.2 ± 11.1 months, this resolution rate being significantly higher in the patients without goitre: 94.9% (95% confidence interval [CI]: 81.2-99.3%) vs 28.6% (95% CI: 4.4-37.7%), p < .05, and with negative antithyroid antibodies: 89.7% (95% CI: 74.6-96.2%), vs 42.9% (95% CI: 20.7–56%), p < .05). Fifteen patients (28.3%) were treated with levothyroxine.

Conclusions

The subclinical hypothyroidism that appears in early infancy in DS is usually transient. The absence of goitre and antibodies is associated with a higher spontaneous resolution rate.