唐氏综合征（DS）中的促甲状腺激素神经分泌功能障碍（TSH-nd）：进展为桥本甲状腺炎的风险较低。
TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis.
作者信息
Faria Claudia Dutra Costantin, Ribeiro Simone, Kochi Cristiane, Silva Aryane Pereira Neves da, Ribeiro Bruna Natalia Freire, Marçal Lilian Teixeira, Santos Felipe Henrique Yyazawa, Eduardo Calliari Procópio Luis, Monte Osmar, Longui Carlos Alberto
机构信息
Pediatric Endocrinology Unit, Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2011 Nov;55(8):628-31. doi: 10.1590/s0004-27302011000800018.
INTRODUCTION
Patients with Down syndrome (DS) often have elevated TSH (hypothalamic origin), which is called TSH neurosecretory dysfunction (TSH-nd). In these cases, there is slight elevation in TSH (5-15 µUI/mL), with normal free T4 and negative thyroid antibodies (AB).
OBJECTIVE
To recognize the risk of progression to Hashimoto's thyroiditis (HT).
SUBJECTS AND METHODS
We retrospectively analyzed 40 DS patients (mean age = 4.5 years), followed up for 6.8 years.
RESULTS
HT was diagnosed in 9/40 patients, three early in monitoring, and six during evolution. In 31/40 patients, TSH-nd diagnosis remained unchanged over the years, with maximum TSH values ranging from 5 to 15 µUI/mL. In this group, free T4 also remained normal and AB were negative. There was a significant TSH reduction (p = 0.017), and normal TSH concentrations (< 5.0 µUI/mL) were observed in 29/31 patients, in at least one moment. No patient had TSH > 15 µUI/mL.
CONCLUSION
DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males).
引言
唐氏综合征（DS）患者常出现促甲状腺激素升高（源于下丘脑），这被称为促甲状腺激素神经分泌功能障碍（TSH-nd）。在这些病例中，促甲状腺激素有轻微升高（5 - 15 μUI/mL），游离甲状腺素正常且甲状腺抗体（AB）阴性。
目的
识别进展为桥本甲状腺炎（HT）的风险。
对象与方法
我们回顾性分析了40例DS患者（平均年龄 = 4.5岁），随访6.8年。
结果
40例患者中有9例诊断为HT，3例在监测早期，6例在病程中。在40例患者中的31例，多年来TSH-nd诊断未变，促甲状腺激素最高值在5至15 μUI/mL之间。在该组中，游离甲状腺素也保持正常且抗体阴性。促甲状腺激素有显著降低（p = 0.017），在31例患者中的29例至少在某一时刻观察到促甲状腺激素浓度正常（< 5.0 μUI/mL）。没有患者促甲状腺激素> 15 μUI/mL。
结论
患有TSH-nd的DS患者进展为HT的风险较低（女性为10%，男性为6%）。
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