Disfunção neurossecretora de TSH na síndrome de Down: baixo risco de progressão para a tireoidite de Hashimoto

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 mu UI/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 mu UI/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 ( 15 mu UI/mL. Conclusion: DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males). Arq Bras Endocrinol Metab. 2011;55(8):628-31Fac Ciencias Med Santa Casa Sao Paulo, Dept Physiol, BR-01221020 Sao Paulo, BrazilISCMSP, Dept Pediat, Pediat Endocrinol Unit, Sao Paulo, BrazilWeb of Scienc