Endocrine Abstracts

Subclinical hypothyroidism (SH) is a biochemical condition defined by increased TSH serum concentration above the normal range associated with normal concentrations of T4 and Free T4. In children SH is often a benign and remitting condition, for which risk of progression to overt hypothyroidism depends on the underlying cause (i.e. autoimmune SH is associated with an increased risk whereas non–autoimmune with a low risk of progression to overt hypothyroidism). The major concern regarding SH is to establish whether this condition should always be considered an expression of mild thyroid dysfunction. Growth and neurocognitive outcome in children do not appear to be affected by SH, however recent data suggest that mild SH may be associated with subtle pro-atherogenic abnormalities. The benefits of levothyroxine therapy are far from clear, therefore the optimum management of children with SH remains a matter of debate and depends on the etiology and degree of TSH elevation and should be individually tailored.