Incidence and etiology of thyroid disorders in children

Sailendra Kumar Yelluri


Background: The prevalence of thyroid disorders is known to be influenced by environmental factors especially iodine deficiency. The most common cause of hypothyroidism in children is autoimmune thyroiditis, which leads to Hashimoto thyroiditis and lymphocyte thyroiditis. Hyperthyroidism is comparatively rare now due to increase in iodine content, but if present it causes rapid linear growth and skeletal growth due to increase in metabolic activity. This study was hence conducted to identify the types of thyroid diseases in our area as well as try to identify the etiology.

Methods: 63 children who were suspected of thyroid disorders. Thorough demographic details, physical and clinical examination was done for all the patients. Blood samples were taken from all the patients for T3, T4 and TSH estimation.

Results: A female predominance of 2:1 was observed over males. Euthyroid was observed in 58.3% of the cases, followed by 30.6% of hypothyroid and 11.1% hyperthyroid. The most common cause was found to be acquired hypothyroidism (47.2%), followed by congenital hypothyroidism (22.2%) and goiter (22.2%). Autoimmunie thyroid disorders accounted for 8.3% of the cases.

Conclusions: Autoimmune disorders, congenital hypothyroidism and acquired hypothyroidism being the common causes of thyroid disorders with females more prone to than males. Since in the long run, hypothyroidism can lead to cardiovascular diseases, it is advisable to identify this disorder as soon as possible so that effective treatment can be started immediately.


Hypothyroidism, Hyperthyroidism, Paediatric age, Congenital hypothyroidism, Acquired hypothyroidism

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Vanderpump MPJ, Tunbridge WMG. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s the thyroid. Philadelphia: Lippincott-Raven. 1996:474-82.

Dunn JT, Pretell EA, Daza CH, Viteri FE. Towards the eradication of endemic goiter, cretinism and iodine deficiency. Pan American Health Organization. Washington: WHO; Scientific publication. 1986;502:215-370.

Delange F. The disorders induced by iodine deficiency. Thyroid. 1994;4:107-28.

Desai MP. Disorders of thyroid gland in India. The Indian Journal of Pediatrics. 1997;64:11-20.

Desai MP. Thyroid functions in children. Journal Of The Associations of Physicians of India. Special Issue on thyroid. 2011.

Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001;345:260-5.

Roberts CG, Ladenson PW. Hypothyroidism. Lancet. 2004;363:793-803.

Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24:1-13.

Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31:702-55.

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA. Serum TSH, T (4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) J Clin Endocrinol Metab. 2002;87:489-99.

Hoogendoorn EH, Hermus AR, de Vegt F, Ross HA, Verbeek AL, Kiemency LA. Thyroid function and prevalence of anti-thyroperoxidase antibodies in a population with borderline sufficient iodine intake: Influences of age and sex. Clin Chem. 2006;52:104-11.

Bemben DA, Hamm RM, Morgan L, Winn P, Davis A, Barton E. Thyroid disease in the elderly. Part 2. Predictability of subclinical hypothyroidism. J Fam Pract. 1994;38:583-8.

Sood A, Pandav CS, Anand K, Sankar R, Karmarkar MG. Relevance and importance of universal salt iodization in India. Natl Med J India. 1997;10:290-3.

Kapil U, Saxena N, Ramachandran S, Balamurugan A, Nayar D, Prakash S. Assessment of iodine deficiency disorders using the 30 cluster approach in the National Capital Territory of Delhi. Indian Pediatr. 1996;33:1013-7.

Dodd NS, Godhia ML. Prevalence of iodine deficiency disorders in adolescents. Indian J Pediatr. 1992;59:585-91.

Tiwari BK, Ray I, Malhotra RL. New Delhi: Government of India. Policy Guidelines on National Iodine Deficiency Disorders Control Programme-Nutrition and IDD Cell. Directorate of Health Services, Ministry of Health and Family Welfare. ; 2006:1-22.

Toteja GS, Singh P, Dhillon BS, Saxena BN. Iodine deficiency disorders in 15 districts of India. Indian J Pediatr. 2004;71:25-8.

Marwaha RK, Tandon N, Gupta N, Karak AK, Verma K, Kochupillai N. Residual goitre in the postiodization phase: Iodine status, thiocyanate exposure and autoimmunity. Clin Endocrinol (Oxf). 2003;59:672-81.

Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical Hypothyroidism and the Risk of Coronary Heart Disease and Mortality, Jour-nal of the American Medical Association (JAMA). 2010;304,12:1365-74.

Rodondi N, Aujesky D, Vittinghoff E, Cornuz J, Bauer DC. Subclinical Hypothyroidism and the Risk of Coronary Heart Disease: A Meta-Analysis, American Journal of Medicine. 2006;119(7):541-51.

Weetman AP, McGregor AM. Autoimmune Thy-roid Disease: Developments in Our Understanding, En-docrine Reviews. 1984;5(2):309-55.

Mariotti S, Caturegli P, Piccolo P, Barbesino G, Pinchera A. Antithyroid Peroxidase Autoantibodies in Thyroid Diseases, The Journal of Clinical Endocrinol-ogy & Metabolism. 1990;71,3:661-9.

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological Prospective. Indian J Endocrine Metab. 2011;(l2):S78-S81.

Desai MP, Karandikar S. Autoimmune Thyroid Disease In Childhood. Indian Pediatrics. 1999;36:659-68.

Hunter I, Greene SA, McDonald TM, Morris AD. Archieves: Diseases of childhood September. 2000;83:207-10.

Shah NA, Modi PJ, Bhalodia JN, Desai NJ. Evaluation of thyroid diseases by hormonal analysis in pediatric age group. National journal of medical research. 2013;3(4):367-70.

Rallison ML, Dobyns BM, Meikle AM, Bishop M, Lyon JL, Stevens WS. Natural history of thyroid abnormalities: prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. Am J Med. 1991;91:363-70.

Jaksic J, Dumic MJ, Filipovic B, Ille J, Cvijetic M, Gjuric G. Thyroid diseases in a school population with thyromegaly. Arch Dis Child. 1994;70:103-6.

Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR. Rising incidence of type 1 diabetes in Scottish children, 1984-93. The Scottish Study Group for the Care of Young Diabetics. Arch Dis Child. 1997;77:210-13.