Endocrine Abstracts

Background: Juvenile hypothyroidism is very common problem in developing part of world, and produces various skeletal manifestations and one of them is short stature and it is the most common reason for referral to endocrinologist. It has very wide etiology and one of them is hypothyroidism, which needs special attention, as the treatment impact of thyroxin replacement has favourable outcome.

Aim and objectives: To study the prevalence of juvenile hypothyroidism, to study the various radiological manifestation of juvenile hypothyroidism and to study the impact of treatment on short stature.

Materials and methods: Out of total 900 patients, 87 patients found to be of juvenile hypothyroidism were enrolled in the study that were 6–18 years of age with newly diagnosed or on follow in the OPD of Department of Endocrinology and Metabolism over a period of 1½ years were evaluated clinically and by laboratory tests. Serial assays of TSH, T₄, T₃ and skeletal X-rays were done and clinical and radiological outcome of patients were analysed.

Statistical analysis: Data were analysed by SPSS version 17 and were presented in the values of mean, median, and percentages. The P-value of <0.05 was considered significant.

Results: The mean age of diagnosis of juvenile hypothyroidism was 11.2 years, and the females had twice the incidence than that of males, the mean TSH value were 118 μIU/ml while T₄ and T₃ were very low. Marked improvement in the anthropometry was seen in comparison to the initial assessment which was well correlated with the normalisation of the TSH level and the X-ray of the bone. The maximum impact of hypothyroidism was on delayed bone age.

Conclusion: Juvenile hypothyroidism, constituent about 10% of total hypothyroid patients and it is more common than congenital hypothyroidism. The presentations may be varied including short stature, spondylolisthesis, delayed bone age and irregular ossification of the epiphyses. Prompt recognition of the findings can lead to early and effective treatment, and improving the skeletal defects.