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Age-Related Patterns of Thyroid-Stimulating Hormone Response to Thyrotropin-Releasing Hormone Stimulation in Down Syndrome

Age-Related Patterns of Thyroid-Stimulating Hormone Response to Thyrotropin-Releasing Hormone... Abstract • Thyroid function in subjects with Down syndrome was studied using the thyrotropin-releasing hormone test. Forty-seven infants and children with Down syndrome were investigated. Ages ranged from 1 month to 7 years; there were 26 boys and 21 girls. Fourteen of the subjects with Down syndrome who had an exaggerated thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation had two or more annual follow-up tests. The remaining 33 subjects who only underwent one thyrotropin-releasing hormone test were compared with 22 age-matched controls (11 boys and 11 girls). Mean basal thyroxine 4 and triiodothyronine 3 values were in the normal ranges. All thyroid antibody titers were negative. Mean basal thyroid-stimulating hormone levels of subjects with Down syndrome were significantly higher than those of controls for all ages, even though there was a decline in thyroid-stimulating hormone levels in both groups. Peak thyroid-stimulating hormone response levels were significantly greater in the subjects with Down syndrome than in the controls. Longitudinal study of the 14 children with Down syndrome with an exaggerated thyroid-stimulating hormone response showed that the response remained exaggerated until the third year of life, when it declined to normal levels. Thyroid dysfunction during the growth spurt of infancy or delayed maturation of the hypothalamic pituitary thyroid axis are proposed mechanisms. (AJDC. 1991;145:172–175) References 1. Murdoch JC, Ratcliffe WA, McLarty DG, Rodger JC, Ratcliffe JG. Thyroid function in adults with Down's syndrome . Biol Psychiatry . 1979;14:463-471. 2. Baxter RG, Larkins RG, Martin FIR. Down's syndrome and thyroid function in adults . Lancet . 1975;2:794-796.Crossref 3. Sare Z, Ruvalcaba RH, Kelly VC. Prevalence of thyroid disorders in Down's syndrome . Clin Genet . 1978;14:154-158.Crossref 4. Loudon MM, Day RE, Duke EMC. Thyroid dysfunction in Down's syndrome . AJDC . 1985;60:1149-1151. 5. Fort P, Lifshitz R, Bellisario R, et al. Abnormalities of thyroid function in infants with Down syndrome . J Pediatr . 1984; 104:545-549.Crossref 6. Pueschel SM, Pezzulo JC. Thyroid dysfunction in Down syndrome . AJDC . 1985;139:636-638. 7. Cutler T, Benezra-Obeiter R, Brink SJ. Thyroid function in young children with Down syndrome . AJDC . 1986;140:479-483. 8. Sharav T, Collins RM, Baab PJ. Growth studies in infants and children with Down's syndrome and elevated levels of thyrotropin . AJDC . 1988;142:1302-1306. 9. Grunesco de Papendieck L, lorcansky S, Rivarols MA, Heinrich JJ, Bergada C. Patterns of TSH response to TRH in children with hypopituitarism . J Pediatr . 1982;100:387-392.Crossref 10. Illig R, Krawczynska H, Torresani T, Prader A. Elevated plasma TSH and hypothyroidism in children with hypothalamic hypopituitarism . J Clin Endocrinol Metab . 1977;44:453-458.Crossref 11. Patel YC, Burger HG, Hudson B. Radioimmunoassay of serum thyrotropin: sensitivity and specificity . J Clin Endocrinol Metab . 1971;31:768-773.Crossref 12. Fisher AD. Thyroid physiology and function tests in infancy and childhood . In: Wermer SC, Ingabar SH, eds. The Thyroid: A Fundamental and Clinical Text . New York, NY: Harper & Row Publishers Inc; 1978:375-383. 13. SAS/STAT Guide for Personal Computers, Version 6 . Cary, NC: SAS Institute Inc; 1985:56-82. 14. Cole JWL, Grizzle JE. Application of multivariate analysis of variance of repeated measurements . Biometrics . 1966;122:810-828.Crossref 15. Wolter R, Bourdoux R, Ermans AM. TSH response to TRH according to age . Pediatr Res . 1982;16:896. 16. Delange F, Dodion J, Walter R, et al. Transient hypothyroidism in the newborn infant . J Pediatr . 1978;92:974-976.Crossref 17. Barmasch M, Kuschiner A, Fontana O, Starface R, Velasquez B, Degrossi OJ. Elevated neonatal thyrotropin (TSH) values in non-hypothyroid newborns: differentiation with congenital hypothyroidism: iodine deficiency disorders and congenital hypothyroidism. In: Proceedings of the Satellite meeting 9th International Thyroid Congress. Sao Paulo, Brazil; May 1985;276-283. 18. Faglia G, Bitensky L, Pinchera A, et al. Thyrotropin secretion in patients with central hypothyroidism: evidence for reduced activity in immunoreactive thyrotropin . J Clin Endocrinol Metab . 1979;48:989-996.Crossref 19. Beck-Peccoz P, Amr S, Menezes-Ferreira M, Faglia G, Weintraub BD. Decreased receptor binding of biologically inactive thyrotropin in central hypothyroidism . N Engl J Med . 1985;312:1085-1090.Crossref 20. Sara V, Gustavson KH, Anneren G, Hall K, Wetterberg L. Somatomedins in Down's syndrome . Biol Psychiatry . 1983;18:803-811. 21. Sato T, Sluzuki J, Takentani T, Ishiguro K, Nakajima H. Age-related change in pituitary threshold for TSH release during thyroxine replacement therapy for cretinism . J Clin Endocrinol Metab . 1977;44:553-559.Crossref 22. Schultz RM, Glassman MS, MacGillivary MH. Elevated threshold for thyrotropin suppression in congenital hypothyroidism . AJDC . 1980;134:19-20. 23. Weintraub BD, Gershengorn MD, lone A, Kourides IA, Fein H. Inappropriate secretion of thyroid-stimulating hormone . Ann Intern Med . 1981;95:339-351.Crossref 24. Scott BS, Petit TL, Becker LE, Edwards BAV. Abnormal electric membrane properties of Down's syndrome DRG neurones in cell culture . Dev Brain Res . 1982;2:257-270.Crossref 25. McSwiggan JD, Hanson DR, Lubiniecki A, Heston LL, Sheppard JR. Down syndrome fibroblasts are sensitive to betaadrenergic stimulation . Proc Natl Acad Sci U S A . 1981;78:7670-7673.Crossref 26. Koch R, Share J, Graliker B. The effects of Cytomel on young children with Down syndrome (mongolism): a double blind longitudinal study . J Pediatr . 1965;66:776-778.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Age-Related Patterns of Thyroid-Stimulating Hormone Response to Thyrotropin-Releasing Hormone Stimulation in Down Syndrome

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1991.02160020064018
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Abstract

Abstract • Thyroid function in subjects with Down syndrome was studied using the thyrotropin-releasing hormone test. Forty-seven infants and children with Down syndrome were investigated. Ages ranged from 1 month to 7 years; there were 26 boys and 21 girls. Fourteen of the subjects with Down syndrome who had an exaggerated thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation had two or more annual follow-up tests. The remaining 33 subjects who only underwent one thyrotropin-releasing hormone test were compared with 22 age-matched controls (11 boys and 11 girls). Mean basal thyroxine 4 and triiodothyronine 3 values were in the normal ranges. All thyroid antibody titers were negative. Mean basal thyroid-stimulating hormone levels of subjects with Down syndrome were significantly higher than those of controls for all ages, even though there was a decline in thyroid-stimulating hormone levels in both groups. Peak thyroid-stimulating hormone response levels were significantly greater in the subjects with Down syndrome than in the controls. Longitudinal study of the 14 children with Down syndrome with an exaggerated thyroid-stimulating hormone response showed that the response remained exaggerated until the third year of life, when it declined to normal levels. Thyroid dysfunction during the growth spurt of infancy or delayed maturation of the hypothalamic pituitary thyroid axis are proposed mechanisms. (AJDC. 1991;145:172–175) References 1. Murdoch JC, Ratcliffe WA, McLarty DG, Rodger JC, Ratcliffe JG. Thyroid function in adults with Down's syndrome . Biol Psychiatry . 1979;14:463-471. 2. Baxter RG, Larkins RG, Martin FIR. Down's syndrome and thyroid function in adults . Lancet . 1975;2:794-796.Crossref 3. Sare Z, Ruvalcaba RH, Kelly VC. Prevalence of thyroid disorders in Down's syndrome . Clin Genet . 1978;14:154-158.Crossref 4. Loudon MM, Day RE, Duke EMC. Thyroid dysfunction in Down's syndrome . AJDC . 1985;60:1149-1151. 5. Fort P, Lifshitz R, Bellisario R, et al. Abnormalities of thyroid function in infants with Down syndrome . J Pediatr . 1984; 104:545-549.Crossref 6. Pueschel SM, Pezzulo JC. Thyroid dysfunction in Down syndrome . AJDC . 1985;139:636-638. 7. Cutler T, Benezra-Obeiter R, Brink SJ. Thyroid function in young children with Down syndrome . AJDC . 1986;140:479-483. 8. Sharav T, Collins RM, Baab PJ. Growth studies in infants and children with Down's syndrome and elevated levels of thyrotropin . AJDC . 1988;142:1302-1306. 9. Grunesco de Papendieck L, lorcansky S, Rivarols MA, Heinrich JJ, Bergada C. Patterns of TSH response to TRH in children with hypopituitarism . J Pediatr . 1982;100:387-392.Crossref 10. Illig R, Krawczynska H, Torresani T, Prader A. Elevated plasma TSH and hypothyroidism in children with hypothalamic hypopituitarism . J Clin Endocrinol Metab . 1977;44:453-458.Crossref 11. Patel YC, Burger HG, Hudson B. Radioimmunoassay of serum thyrotropin: sensitivity and specificity . J Clin Endocrinol Metab . 1971;31:768-773.Crossref 12. Fisher AD. Thyroid physiology and function tests in infancy and childhood . In: Wermer SC, Ingabar SH, eds. The Thyroid: A Fundamental and Clinical Text . New York, NY: Harper & Row Publishers Inc; 1978:375-383. 13. SAS/STAT Guide for Personal Computers, Version 6 . Cary, NC: SAS Institute Inc; 1985:56-82. 14. Cole JWL, Grizzle JE. Application of multivariate analysis of variance of repeated measurements . Biometrics . 1966;122:810-828.Crossref 15. Wolter R, Bourdoux R, Ermans AM. TSH response to TRH according to age . Pediatr Res . 1982;16:896. 16. Delange F, Dodion J, Walter R, et al. Transient hypothyroidism in the newborn infant . J Pediatr . 1978;92:974-976.Crossref 17. Barmasch M, Kuschiner A, Fontana O, Starface R, Velasquez B, Degrossi OJ. Elevated neonatal thyrotropin (TSH) values in non-hypothyroid newborns: differentiation with congenital hypothyroidism: iodine deficiency disorders and congenital hypothyroidism. In: Proceedings of the Satellite meeting 9th International Thyroid Congress. Sao Paulo, Brazil; May 1985;276-283. 18. Faglia G, Bitensky L, Pinchera A, et al. Thyrotropin secretion in patients with central hypothyroidism: evidence for reduced activity in immunoreactive thyrotropin . J Clin Endocrinol Metab . 1979;48:989-996.Crossref 19. Beck-Peccoz P, Amr S, Menezes-Ferreira M, Faglia G, Weintraub BD. Decreased receptor binding of biologically inactive thyrotropin in central hypothyroidism . N Engl J Med . 1985;312:1085-1090.Crossref 20. Sara V, Gustavson KH, Anneren G, Hall K, Wetterberg L. Somatomedins in Down's syndrome . Biol Psychiatry . 1983;18:803-811. 21. Sato T, Sluzuki J, Takentani T, Ishiguro K, Nakajima H. Age-related change in pituitary threshold for TSH release during thyroxine replacement therapy for cretinism . J Clin Endocrinol Metab . 1977;44:553-559.Crossref 22. Schultz RM, Glassman MS, MacGillivary MH. Elevated threshold for thyrotropin suppression in congenital hypothyroidism . AJDC . 1980;134:19-20. 23. Weintraub BD, Gershengorn MD, lone A, Kourides IA, Fein H. Inappropriate secretion of thyroid-stimulating hormone . Ann Intern Med . 1981;95:339-351.Crossref 24. Scott BS, Petit TL, Becker LE, Edwards BAV. Abnormal electric membrane properties of Down's syndrome DRG neurones in cell culture . Dev Brain Res . 1982;2:257-270.Crossref 25. McSwiggan JD, Hanson DR, Lubiniecki A, Heston LL, Sheppard JR. Down syndrome fibroblasts are sensitive to betaadrenergic stimulation . Proc Natl Acad Sci U S A . 1981;78:7670-7673.Crossref 26. Koch R, Share J, Graliker B. The effects of Cytomel on young children with Down syndrome (mongolism): a double blind longitudinal study . J Pediatr . 1965;66:776-778.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1991

References