Treatment of hyperthyroidism in down syndrome: case report and review of the literature

Ali, Fawzi E.; Al-Busairi, Waleed A.; Al-Mulla, Fatema A

doi:10.1016/s0891-4222(99)00011-6

Cited by 11 publications

(7 citation statements)

References 16 publications

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“…Most of the large studies of thyroid disorders in DS have originated from the developed Western countries. Except for an earlier case report [20], ours is the first study investigating thyroid function in Kuwaiti subjects with DS.…”

Section: Introductionmentioning

confidence: 80%

Thyroid Function in Kuwaiti Subjects with Down’s Syndrome

et al. 2002

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Objective: To investigate the thyroid function of individuals with Down’s syndrome (DS). Methods: Thyroid function and antithyroid antibodies were measured in 58 Kuwaitis with DS who resided at a residential facility or attended rehabilitation centers. Results: Twenty-six subjects (45%) were euthyroid and 32 (55%) had thyroid dysfunction. One patient had previously been diagnosed with thyroid failure whereas the other 31 patients had newly discovered disease: 9 patients had primary hypothyroidism (T₄ 9.95 ± 1.1 pmol/l and TSH 15.15 ± 11.93 mU/l), 19 subclinical hypothyroidism (TSH 6.47 ± 2.57 mU/l), 1 secondary hypothyroidism, 1 hyperthyroidism, and the remaining 1 subclinical hyperthyroidism. Antithyroid antibodies were found in 52% of the total subjects and in 59% of those with thyroid dysfunction. Conclusions: Thyroid dysfunction is common in Kuwaiti subjects with DS and is presumably the consequence of autoimmune thyroid disease. Periodic thyroid function testing is recommended in individuals with DS, which is best done through a national program.

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Section: Introductionmentioning

confidence: 80%

Thyroid Function in Kuwaiti Subjects with Down’s Syndrome

et al. 2002

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“…Medical treatment requires regular drug assumption, typically for long periods of time and relapse can occur [13; 47]; moreover, some studies have demonstrated a lower efficacy of medical treatment in DS than in general population [46; 47]. On the other side, radioiodine is a definite treatment in the great majority of the cases, although the risk of secondary hypothyroidism; thus, the need of a life-long replacement therapy is high [13]. Surgery should be reserved for those with serious side effects from thyrostatic drugs or requiring rapid resolution of thyrotoxicosis, as craniofacial abnormalities and short neck could make anesthesia difficult in DS patients [24].…”

Section: Hyperthyroidismmentioning

confidence: 99%

Endocrine Autoimmunity in Down's Syndrome

Guaraldi¹,

Giaccherino²,

Lanfranco³

et al. 2017

Frontiers of Hormone Research

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Since the mid 1900s, a significant increase of infectious, hematological, and autoimmune diseases has been reported in patients with Down's syndrome (DS), independent of sex, age, family history, and exposure to other risk factors, suggesting an intrinsic alteration of the immune system. Several in vitro and in vivo studies have demonstrated alterations of both cellular and humoral immunological response mainly, although not exclusively, secondary to alterations of the expression of autoimmune regulator gene (located on chromosome 21), leading to thymic structural and functional impairments. Autoimmune thyroid disorders (i.e. Hashimoto's thyroiditis and Graves' disease) and type 1 diabetes mellitus are the most common autoimmune endocrine disorders associated with DS, and present with some peculiar features. The underlying etiopathogenic mechanisms and clinical significance of some mild laboratory alterations are still poorly understood. For these aspects, together with the associated multiple comorbidities and intellectual impairment - that make DS patients dependent on care givers - and in the absence of definite guidelines, disease management is very challenging and should be patient-tailored.

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“…The population of DS children is specific due to immune defects caused by trisomy 21. Therefore, an aggressive antithyroid therapy can be dangerous, and is contraindicated with concomitant infections [14]. One of the most serious side effect of using tionamids is agranulocytosis (0,1-0,5%) [15].…”

Section: Antithyroid Treatment In Pediatric Populationmentioning

confidence: 99%

“…Radioiodine therapy is chosen in some cases, for instance when the tionamid therapy has failed, or when there are some contraindications, or when quick remission of hyperthyroidism is required [14]. Rivkees et al described the treatment of 1200 pediatric patients that started radioiodine 131I therapy after the age of 1 year old.…”

Section: Radioiodine Treatment In Pediatric Populationmentioning

confidence: 99%