Virmani A, Menon P S, Karmarkar M G, Kochupillai N, Seth V, Ghai O P, Gopinath P G
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
Ann Trop Paediatr. 1987 Sep;7(3):205-9. doi: 10.1080/02724936.1987.11748508.
Fifty-five children with short stature were investigated for the aetiology of short stature with special reference to hypothyroidism. Clinical and laboratory parameters including anthropometry were determined to exclude any chronic systemic disorders. Thyroid function tests such as thyroxine (T4) and thyroid stimulating hormone (TSH) estimation by radioimmunoassay, radioactive iodine uptake and thyroid scan, using 131I and perchlorate discharge test, were performed. In addition, growth hormone was estimated under basal conditions and after insulin-induced hypoglycaemia. Thirty-five were boys and 20 were girls. The age at presentation in the boys was 3-12 years whereas in the girls it was 8-13 years. Forty-three of the 55 children had delayed bone age. Abnormal thyroid function was present in 25 children (45.45%). Of these, 11 (20%) had primary hypothyroidism with low or normal uptake, whereas 14 (25.45%) had glands with high uptake of 131I and elevated TSH. Three children with primary hypothyroidism had reduced growth hormone reserve. On follow-up with thyroxine, there was an increase in growth velocity in all. This study indicates that thyroid function tests should be performed routinely in children with undiagnosed short stature.
对55名身材矮小的儿童进行了调查，以研究身材矮小的病因，特别关注甲状腺功能减退症。测定了包括人体测量学在内的临床和实验室参数，以排除任何慢性全身性疾病。进行了甲状腺功能测试，如通过放射免疫分析法测定甲状腺素（T4）和促甲状腺激素（TSH）、放射性碘摄取和甲状腺扫描（使用131I）以及过氯酸盐释放试验。此外，在基础条件下和胰岛素诱导的低血糖后测定生长激素。其中35名是男孩，20名是女孩。男孩就诊时的年龄为3至12岁，而女孩为8至13岁。55名儿童中有43名骨龄延迟。25名儿童（45.45%）存在甲状腺功能异常。其中，11名（20%）患有原发性甲状腺功能减退症，摄取率低或正常，而14名（25.45%）的甲状腺对131I摄取高且TSH升高。3名原发性甲状腺功能减退症儿童的生长激素储备减少。在接受甲状腺素治疗的随访中，所有人的生长速度都有所增加。这项研究表明，对于未确诊的身材矮小儿童，应常规进行甲状腺功能测试。
