Study of clinical and biochemical profile of subclinical hypothyroidism in children aged 2-12 years


  • Poornachand V. Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, India
  • Kumarasamy K. Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, India
  • Seenivasan V. Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, India
  • Karamath S. P. Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, India



Autoimmune thyroid disease, Blood pressure, Cardiovascular morbidity, Lipid abnormalities


Background: Subclinical hypothyroidism is quite a common clinical condition in pediatric population. Objective of this study was to understand the clinical and biochemical profile of Subclinical hypothyroidism in children attending endocrinology OPD at a tertiary care center in southern India.

Methods: In this study 62 children diagnosed with subclinical hypothyroidism. Clinical assessment and laboratorial evaluation was carried out in a systematic way. Symptomatology, anthropometry, measurement of vital parameters such as heart rate, blood pressure, tests for anti-thyroid antibody, lipid profile, estimation of bone age, USG neck, assessment of left ventricular function using M-mode echo were carried out at the time of diagnosis.

Results: Subclinical hypothyroidism is more common in female children, principle symptoms were neck swelling and weight gain, goitrous autoimmune thyroiditis is more common in female, significant number of children had positive anti-thyroid antibodies, mean TSH value of patients with positive anti-thyroid antibody was high, there was no delay in bone maturation in majority of children, both systolic and diastolic blood pressure were high, these children had abnormal lipid profile, heart rate and left ventricular function were normal.

Conclusions: Subclinical hypothyroid children have higher risk of hypertension and pro-atherogenic lipid abnormalities. As there is a risk of progression to overt hypothyroidism these children needs regular follow up. 


Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al. Subclinical thyroid disease. Scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2);228-38.

Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocrine Reviews. 2008;29(1):76-131.

Wu T, Flowers JW, Tudiver F, Wilson JL, Punyasavatsut N. Subclinical thyroid disorders and cognitive performance among adolescents in the United States. BMC Pediatrics. 2006;16(12):2006.

Cooper DS. Subclinical hypothyroidism. Thyroid Res Pract. 2013;10:9-11.

Cerbone M, Capalbo D, Wasniewska M, Mattace Raso G, Alfano S, Meli R, et al. Cardiovascular risk factors in children with long-standing untreated idiopathic subclinical hypothyroidism. Clin Endocrinol Metab. 2014;99(8):2697-703.

Daniels SR, Greer FR. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122(1):198-208.

Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S. Natural history of euthyroid Hashimoto’s thyroiditis in children. J Pediatr. 2006;149:827-32.

Zois C, Stavrou I, Svarna E, Seferiadis K, Tsatsoulis A. Natural course of autoimmune thyroiditis after elimination of iodine deficiency in northwestern Greece. Thyroid. 2016;16:289-93.

Gopalakrishnan S, Chugh PK, Chhillar M, Ambardar VK, Sahoo M, Sankar R. Goitrous autoimmune thyroiditis in a pediatric population: a longitudinal study. Pediatrics. 2008;122:670-74.

Chen H, Xi Q, Zhang H, Song B, Liu X, Mao X, et al. Investigation of thyroid function and blood pressure in school aged subjects without overt thyroid disease. Endocrine. 2012;41(1):122-9.

Ittermann T, Thamm M, Wallaschofski H, Rettig R, Volzke H. Serum thyroid stimulating hormone levels is associated with blood pressure in children and adolescents. J Clin Endocrinol Metabol. 2012;97(3):828-34.

Di Mase R, Cerbone M, Improda N, Esposito A, Capalbo D, Mainolfi C, et al. Bone health in children with long-term idiopathic subclinical hypothyroidism. Ital J Pediatr. 2012;38(1):56.






Original Research Articles