Investigating the Presence of Transient Hyperthyrotropinemia and Other Thyroid Hormone Abnormalities in Children with Acute Infections and Determining the Frequency of Follow-up

Project no. 27371 · Status: Kapanmış (Yayın bekleniyor) · 2023

Summary

<p>Acute&nbsp;infections&nbsp;may&nbsp;cause&nbsp;transient&nbsp;alterations&nbsp;in&nbsp;thyroid&nbsp;function&nbsp;in&nbsp;children.&nbsp;This&nbsp;prospective&nbsp;study&nbsp;investigated&nbsp;thyroid&nbsp;function&nbsp;test&nbsp;dynamics&nbsp;in&nbsp;children&nbsp;aged&nbsp;2–18&nbsp;years&nbsp;with&nbsp;non-severe&nbsp;acute&nbsp;infections.&nbsp;Of&nbsp;91&nbsp;initially&nbsp;enrolled&nbsp;patients,&nbsp;one&nbsp;was&nbsp;excluded&nbsp;following&nbsp;a&nbsp;diagnosis&nbsp;of&nbsp;autoimmune&nbsp;thyroiditis&nbsp;during&nbsp;follow-up,&nbsp;leaving&nbsp;90&nbsp;patients&nbsp;for&nbsp;analysis.&nbsp;TSH,&nbsp;free&nbsp;T3&nbsp;(fT3),&nbsp;free&nbsp;T4&nbsp;(fT4),&nbsp;and&nbsp;reverse&nbsp;T3&nbsp;(rT3)&nbsp;were&nbsp;measured&nbsp;at&nbsp;the&nbsp;acute&nbsp;phase&nbsp;(V1),&nbsp;day&nbsp;14&nbsp;(V2),&nbsp;and&nbsp;day&nbsp;30&nbsp;(V3).&nbsp;Reverse&nbsp;T3&nbsp;measurements&nbsp;were&nbsp;performed&nbsp;using&nbsp;a&nbsp;Human&nbsp;rT3&nbsp;ELISA&nbsp;kit&nbsp;procured&nbsp;within&nbsp;the&nbsp;scope&nbsp;of&nbsp;this&nbsp;project.</p><p>Contrary&nbsp;to&nbsp;the&nbsp;initial&nbsp;hypothesis,&nbsp;the&nbsp;predominant&nbsp;finding&nbsp;was&nbsp;not&nbsp;hyperthyrotropinemia&nbsp;but&nbsp;mild&nbsp;TSH&nbsp;suppression&nbsp;during&nbsp;the&nbsp;acute&nbsp;phase,&nbsp;followed&nbsp;by&nbsp;a&nbsp;statistically&nbsp;significant&nbsp;rise&nbsp;during&nbsp;convalescence&nbsp;(p=0.012).&nbsp;Serum&nbsp;fT3&nbsp;levels&nbsp;were&nbsp;significantly&nbsp;suppressed&nbsp;during&nbsp;the&nbsp;acute&nbsp;phase&nbsp;and&nbsp;increased&nbsp;by&nbsp;day&nbsp;14&nbsp;(p&lt;0.001).&nbsp;Serum&nbsp;fT4&nbsp;remained&nbsp;stable&nbsp;across&nbsp;all&nbsp;time&nbsp;points&nbsp;(p=0.368).&nbsp;Reverse&nbsp;T3&nbsp;levels&nbsp;were&nbsp;predominantly&nbsp;below&nbsp;the&nbsp;assay&nbsp;detection&nbsp;limit&nbsp;throughout&nbsp;the&nbsp;study&nbsp;period,&nbsp;with&nbsp;no&nbsp;significant&nbsp;change&nbsp;across&nbsp;visits&nbsp;(p=0.638).&nbsp;Serum&nbsp;fT3&nbsp;showed&nbsp;significant&nbsp;inverse&nbsp;correlations&nbsp;with&nbsp;both&nbsp;CRP&nbsp;and&nbsp;procalcitonin.</p><p>These&nbsp;findings&nbsp;indicate&nbsp;that&nbsp;thyroid&nbsp;hormone&nbsp;alterations&nbsp;in&nbsp;children&nbsp;with&nbsp;non-severe&nbsp;acute&nbsp;infections&nbsp;represent&nbsp;a&nbsp;mild,&nbsp;self-limiting&nbsp;pattern&nbsp;distinct&nbsp;from&nbsp;classical&nbsp;non-thyroidal&nbsp;illness&nbsp;syndrome,&nbsp;resolving&nbsp;spontaneously&nbsp;within&nbsp;30&nbsp;days.&nbsp;In&nbsp;light&nbsp;of&nbsp;these&nbsp;findings,&nbsp;routine&nbsp;thyroid&nbsp;function&nbsp;testing&nbsp;may&nbsp;not&nbsp;be&nbsp;recommended&nbsp;during&nbsp;acute&nbsp;infection&nbsp;in&nbsp;the&nbsp;absence&nbsp;of&nbsp;clinical&nbsp;signs&nbsp;of&nbsp;thyroid&nbsp;disease.</p>

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