Palabras clave
adolescente
tratamiento farmacológico
terapéutica
tirotropina
tiroxina
hipotiroidismo
bocio
enfermedad tiroidea
etiología
Cómo citar
Resumen
Contexto: el hipotiroidismo subclínico se define como el hallazgo de un nivel de tirotropina por encima del límite superior del rango de referencia del laboratorio, asociado a valores de tiroxina libre y triyodotironina total normales, sin manifestaciones clínicas francas de hipofunción tiroidea. En niños y adolescentes, la terapia farmacológica en el hipotiroidismo subclínico leve no tiene indicaciones bien establecidas.
Objetivo: resaltar los criterios etiológicos, clínicos y bioquímicos que pueden favorecer la decisión del tratamiento con levotiroxina en hipotiroidismo subclínico en pediatría.
Metodología: mediante la revisión de la literatura, se buscó evidencia sobre hipotiroidismo subclínico en menores de 18 años y las consideraciones para el uso de suplencia de levotiroxina.
Resultados: el hipotiroidismo subclínico en pediatría puede ser transitorio o evolucionar a hipotiroidismo manifiesto. La etiología más común de hipotiroidismo subclínico en pediatría es la autoinmune, sin embargo, en muchas ocasiones no se logra identificar la causa subyacente. Existen factores como el aumento progresivo de la tirotropina, la presencia de bocio o la autoinmunidad, que pueden indicar necesidad de suplencia de levotiroxina.
Conclusiones: el manejo en casos de hipotiroidismo subclínico grave es claro, en casos leves (TSH menor de 10mUI/l) se deben explorar factores asociados para decidir el comienzo de levotiroxina.
Citas
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