婴幼儿及青少年甲状腺功能减退症的治疗。

Treatment of hypothyroidism in infants, children and adolescents.

机构信息

Assistant Professor of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.

Associate Professor of Pediatrics, Division of Endocrinology, Yale University, New Haven, CT, USA.

出版信息

Trends Endocrinol Metab. 2022 Jul;33(7):522-532. doi: 10.1016/j.tem.2022.04.007. Epub 2022 May 7.

DOI:10.1016/j.tem.2022.04.007

PMID:35537910

Abstract

In 2014, treatment guidelines from the American Thyroid Association reflected the general consensus that levothyroxine (LT4), adjusted to maintain a normal thyrotropin (TSH) level, is the preferred method for treatment of hypothyroidism. Although this is generally applicable to children, there are subsets of children for whom the diagnosis and treatment of hypothyroidism are problematic. These include children with congenital hypothyroidism (CH), low birth weight (LBW) and very low birth weight (VLBW), Down syndrome (DS), subclinical hypothyroidism, and obesity. In this Review, we focus on the progress and remaining pitfalls in diagnosis and treatment of hypothyroidism in these and other groups.

摘要

2014 年，美国甲状腺协会的治疗指南反映了普遍共识，即左旋甲状腺素（LT4）调整以维持正常促甲状腺素（TSH）水平，是治疗甲状腺功能减退症的首选方法。虽然这通常适用于儿童，但有些儿童的甲状腺功能减退症的诊断和治疗存在问题。这些儿童包括先天性甲状腺功能减退症（CH）、低出生体重（LBW）和极低出生体重（VLBW）、唐氏综合征（DS）、亚临床甲状腺功能减退症和肥胖症。在这篇综述中，我们专注于这些和其他群体中甲状腺功能减退症的诊断和治疗的进展和遗留问题。