Aims and Methods: Thyroid function tests were initially carried out on 122 chi ldren with Down’s syndrome aged 6-14 years and then repeated four to six years later in 103 adolescents (85%of the group of 122) when the...Aims and Methods: Thyroid function tests were initially carried out on 122 chi ldren with Down’s syndrome aged 6-14 years and then repeated four to six years later in 103 adolescents (85%of the group of 122) when they were aged 10-20 y ears (median 14.4 years). At the second test two were hypothyroid and two with i solated raised thyroid stimulating hormone (IRTSH) were receiving thyroxine. Res ults: At the first test there were 98 (80%) euthyroid children: 83 were reteste d and four (5%) had IR-TSH. At the first test 24 had IR-TSH: 20 were retested and 14 (70%) had become normal. Seventeen with IR-TSH on initial testing had a thyrotrophin releasing hormone test within three months; TSH had become normal in eight (47%) of these children. There was no association between reported cl inical symptoms and IR-TSH, but there were clear symptoms in one of the two wit h definite hypothyroidism. Conclusions: The likelihood ratio for a positive resu lt on second testing when raised TSH and positive antibody status on first testi ng are combined is 20. This suggests initial testing results could be used as a basis to select a subgroup for further testing at say five yearly intervals unle ss new symptoms emerge in the interim. It also suggests that yearly screening (a s recommended by the American Academy of Pediatrics, 2001) is probably not justi fied in the first 20 years of life.展开更多
文摘Aims and Methods: Thyroid function tests were initially carried out on 122 chi ldren with Down’s syndrome aged 6-14 years and then repeated four to six years later in 103 adolescents (85%of the group of 122) when they were aged 10-20 y ears (median 14.4 years). At the second test two were hypothyroid and two with i solated raised thyroid stimulating hormone (IRTSH) were receiving thyroxine. Res ults: At the first test there were 98 (80%) euthyroid children: 83 were reteste d and four (5%) had IR-TSH. At the first test 24 had IR-TSH: 20 were retested and 14 (70%) had become normal. Seventeen with IR-TSH on initial testing had a thyrotrophin releasing hormone test within three months; TSH had become normal in eight (47%) of these children. There was no association between reported cl inical symptoms and IR-TSH, but there were clear symptoms in one of the two wit h definite hypothyroidism. Conclusions: The likelihood ratio for a positive resu lt on second testing when raised TSH and positive antibody status on first testi ng are combined is 20. This suggests initial testing results could be used as a basis to select a subgroup for further testing at say five yearly intervals unle ss new symptoms emerge in the interim. It also suggests that yearly screening (a s recommended by the American Academy of Pediatrics, 2001) is probably not justi fied in the first 20 years of life.
