Keywords
Child
Adolescents
Goiter
Therapeutics
Thyroid Diseases
Thyrotropin
Thyroxine
Triiodothyronine
Etiology
Treatment
How to Cite
Abstract
Background: Subclinical hypothyroidism is defined as a thyrotropin level above the upper limit of the lab reference range with normal thyroxine and triiodothyronine concentrations, without overt hypothyroidism symptoms. Treatment in children and adolescents does not have clear indications.
Purpose: Highlight etiology, clinics, and biochemical criteria on the decision to start treatment with levothyroxine in children with subclinical hypothyroidism.
Methodology: A database search on reports for indications of treatment with levothyroxine for subclinical hypothyroidism on patients under eighteen years old was performed.
Results: Pediatric subclinical hypothyroidism can range from a transitory and remitting condition to overt hypothyroidism. The most common diagnosed etiology is autoimmune thyroid disease, but there are several cases in which etiology cannot be identified. Factors like a progressive increase in TSH, goiter or thyroid autoimmunity may indicate supplementation is needed.
Conclusion: Subclinical hypothyroidism's treatment in a severe case is straightforward. In a mild case (TSH lower than 10mUI/l) associated factors should be investigated to initiate treatment with levothyroxine.
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