Subclinical hypothyroidism in children: natural history and when to treat.
Subclinical hypothyroidism in children: natural history and when to treat.
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DOI：
10.4274/jcrpe.851
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发表时间：
2013
影响因子：
1.9
通讯作者：
Monzani A
中科院分区：
文献类型：
--
作者：
Bona G;Prodam F;Monzani A
亚临床甲状腺功能减退症（SH）是一种非常常见的疾病，在儿科年龄组。本文的目的是提出一个审查的研究调查的自然过程中SH和替代疗法的影响，左旋甲状腺素在儿童。我们系统检索了PubMed、科克伦和EMBASE（1990年至2012年），并确定了14篇适合纳入的文章。SH是一种良性过程，不影响人体测量参数或青春期开始，在大多数情况下，它是一种缓解性疾病，发生明显甲状腺功能减退症的风险较低，更频繁地向甲状腺功能正常发展或稳定地保持在孤立的高促甲状腺素血症状态。分析SH替代疗法效果的研究报告称，身材矮小或慢性病儿童的生长速度加快，对甲状腺体积减少产生不一致的影响，并且对神经认知功能没有影响。儿童和青少年的SH通常是一个自我缓解的过程，只有当促甲状腺激素值高于10 mIU/L时，当检测到甲状腺功能受损或甲状腺肿的临床体征或症状时，或当SH与其他慢性疾病相关时，才应考虑治疗。利益冲突：未声明。
Subclinical hypothyroidism (SH) is a quite common disorder in the pediatric age group. The aim of this paper is to present a review of the studies investigating the natural course of SH and the effects of replacement therapy with levothyroxine in childhood. We systematically searched PubMed, Cochrane, and EMBASE (1990 to 2012) and identified 14 articles suitable to be included. SH is a benign process that does not influence anthropometric parameters or puberty onset, and in most cases, it is a remitting disease, with a low risk of development of overt hypothyroidism, more frequently evolving toward euthyroidism or steadily remaining in a condition of isolated hyperthyrotropinemia. Studies analyzing the effects of replacement therapy in SH have reported an increased growth velocity in children with short stature or chronic diseases, discordant effects on thyroid volume reduction, and no effects on neurocognitive function. SH in children and adolescent is often a self-remitting process and its treatment should be considered only when thyroid stimulating hormone values are higher than 10 mIU/L, when clinical signs or symptoms of impaired thyroid function or goiter are detected, or when SH is associated with other chronic diseases. Conflict of interest:None declared.
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