Thyroid dysfunction in Congolese subjects with Down syndrome
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Abstract
Objective: The present study aims to assess the proportion and the pattern of thyroid dysfunction in a population of Congolese subjects with Down Syndrome.
Methods: A total of 34 subjects with Down syndrome were recruited from Lubumbashi (Democratic Republic of Congo). Thyroid morphology was assessed by sonography. Serum T3, T4, FT4, TSH, Thyroglobulin, Thyroid peroxidase antibody (TPOAb) and antithyroglobulin antibody (TgAb) were measured.
Results: The mean age of the patients was 13 years (range: 3 and 47 years). Of 34 Down syndrome subjects, 6 cases (17.6%) were found to have subclinical hypothyroidism. No patient had hyperthyroidism. Among 29 subjects with a thyroid ultrasound imaging, 25 patients (86.2%) were found to have morphological abnormalities of the gland. Regarding thyroid autoantibodies, TPOAb was positive in 1 case (2.9%) and TgAb was positive in 1 case (2.9%).
Conclusion: The results were compared between patients with hypothyroidism and with normal thyroid function. There was no statistical difference in terms of age, sex, nutritional status, antibody levels and thyroid volume between these two groups. Conclusions: In our series, the proportion of hypothyroidism is relatively important but it remains largely under the prevalence reported in international studies.
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References
- Campos C and Casado A. Oxidative stress, thyroid dysfunction & Down syndrome. Indian Journal of Medical Research, 2015, 142(2): 113-119. https://doi.org/10.4103/0971-5916.164218
- Prasher VP. Down syndrome and thyroid disorders: a review. Downs Syndr Res Pract, 1999, 6(1): 25-42. https://doi.org/10.3104/reviews.95
- Roizen NJ, Patterson D. Down’s syndrome. Lancet, 2003, 361(9365): 1281-1289. https://doi.org/10.1016/S0140-6736(03)12987-X
- Jovanovic SV, Clements D and MacLeod K. Biomarkers of oxidative stress are significantly elevated in Down syndrome. Free Radical Biology & Medicine, 1998, 25(9): 1044-1048. https://doi.org/10.1016/S0891-5849(98)00137-3
- Dias VM, Nunes JC, Araujo SS, et al. Etiological assessment of hyperthyrotropinemia in children with Down’s syndrome. Jornal De Pediatria, 2005, 81(1): 79-84. https://doi.org/10.1590/S0021-75572005000100015
- Desai MP. Congenital hypothyroidism: Screening dilemma. Indian Journal of Endocrinology & Metabolism, 2012, 16(Suppl 2): S153-S155. https://doi.org/10.4103/2230-8210.104027
- Zurakowski D, Di CJ and Majzoub JA. Pediatric reference intervals for serum thyroxine, triiodothyronine, thyrotropin, and free thyroxine. Clinical Chemistry, 1999, 45(7): 1087- 1091. https://doi.org/10.1016/S0009-9120(99)00029-6
- Zimmermann MB, Hess SY, Molinari L, et al. New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization/ Nutrition for Health and Development Iodine Deficiency Study Group Report. American Journal of Clinical Nutrition, 2004, 79(2): 231-237. https://doi.org/10.1051/rnd:2004021
- Wang Y, Moss J and Thisted R. Predictors of body surface area. Journal of Clinical Anesthesia, 1992, 4(1): 4-10. https://doi.org/10.1016/0952-8180(92)90111-D
- Delange F. What do we call a goiter? European Journal of Endocrinology, 1999, 140(6): 486-488. https://doi.org/10.1530/eje.0.1400486
- Ali FE, Bayoumy HA, Mohammad AS, et al. Thyroid function in Kuwaiti subjects with Down’s syndrome. Medical Principles & Practice, 2002, 11(4): 206-209. https://doi.org/10.1159/000065807
- Moosa S, Segal DG, Christianson AL, et al. Thyroid dysfunction in a cohort of South African children with Down syndrome. South African medical journal = Suid- Afrikaanse tydskrif vir geneeskunde, 2013, 103(12 Suppl 1): 966-970. https://doi.org/10.7196/samj.7111
- Goday-Arno A, Cerda-Esteva M, Flores-Le-Roux JA, et al. Hyperthyroidism in a population with Down syndrome (DS). Clinical Endocrinology, 2009, 71(1): 110-114. https://doi.org/10.1111/j.1365-2265.2008.03419.x
- Ali FE, Bayoumy HA, Mohammad AS, et al. Thyroid function in Kuwaiti subjects with Down’s syndrome. Medical Principles & Practice, 2002, 11(4): 206-209. https://doi.org/10.1159/000065807
- Zori RT, Schatz DA, Ostrer H, et al. Relationship of autoimmunity to thyroid dysfunction in children and adults with Down syndrome. American Journal of Medical Genetics Part A, 1990, 7: 238-241. https://doi.org/10.1002/ajmg.1320370748
- Zhang X and Ho SM. Epigenetics meets endocrinology. J Mol Endocrinol, 2011, 46(1): R11-R32.
- Yin X, Latif R, Tomer Y, et al. Thyroid epigenetics: X chromosome inactivation in patients with autoimmune thyroid disease. Annals of the New York Academy of ences, 2007, 1110: 193-200. https://doi.org/10.1196/annals.1423.021
- Beutler E and Matsumoto F. Ethnic variation in red cell glutathione peroxidase activity. Blood, 1975, 46(1): 103-110. https://doi.org/10.1016/S0338-4535(76)80038-4
- Ueda D. Normal volume of the thyroid gland in children. Journal of Clinical Ultrasound, 1990, 18(6): 455-462. https://doi.org/10.1002/jcu.1870180602
- Xu F, Sullivan K, Houston R, et al. Thyroid volumes in US and Bangladeshi schoolchildren: comparison with European schoolchildren. European Journal of Endocrinology, 1999, 140(6): 498-504. https://doi.org/10.1530/eje.0.1400498
- Ngo DB, Dikassa L, Okitolonda W, et al. Selenium status in pregnant women of a rural population (Zaire) in relationship to iodine deficiency. Tropical Medicine & International Health, 1997, 2(6): 572-581. https://doi.org/10.1046/j.1365-3156.1997.d01-326.x
- Zori RT, Schatz DA, Ostrer H, et al. Relationship of autoimmunity to thyroid dysfunction in children and adults with Down syndrome. Am J Med Genet, 1990, 7: 238-241. https://doi.org/10.1002/ajmg.1320370748
- Sare Z, Ruvalcaba RH, Kelley VC. Prevalence of thyroid disorder in Down syndrome. Clinical Genetics, 1978, 14(3): 154-158. https://doi.org/10.1111/j.1399-0004.1978.tb02121.x
- Friedman DL, Kastner T, Pond WS, et al. Thyroid dysfunction in individuals with Down syndrome. Archives of Internal Medicine, 1989, 149(9): 1990-1993. https://doi.org/10.1001/archinte.149.9.1990
- Lobo EH, KhanMand Tew J. Community study of hypothyroidism in Down’s syndrome. British Medical Journal, 1980, 280(6226): 1253. https://doi.org/10.1136/bmj.280.6226.1253
- Rubello D, Pozzan GB, Casara D, et al. Natural course of subclinical hypothyroidism in Down’s syndrome: prospective study results and therapeutic considerations. Journal of Endocrinological Investigation, 1995, 18(1): 35-40. https://doi.org/10.1007/BF03349694
- Habimana L, Twite KE, Daumerie C, et al. High prevalence of thyroid dysfunction among pregnant women in Lubumbashi, Democratic Republic of Congo. Thyroid, 2014, 24(3): 568-575. https://doi.org/10.1089/thy.2013.0261
- Lumaka A, Mubungu G, Nsibu C, et al. X-linked adrenal hypoplasia congenita: a novel DAX1 missense mutation and challenges for clinical diagnosis in Africa. European Journal of Pediatrics, 2012, 171(2): 267-270. https://doi.org/10.1007/s00431-011-1523-5