Avaliação do eixo hipotalâmico-hipofisário-tireoidiano em crianças com síndrome de Down | Jornal de Pediatria (original) (raw)
Jornal de Pediatria (English Edition)
ISSN: 0021-7557
Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.
See more
Indexed in:
Scopus, Medline, Directory of Open Access Journals (DOAJ), PubMed Central (PMC), SCImago Journal Rank (SJR), SNIP
See more
Follow us:
Impact factor
The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.
© Clarivate Analytics, Journal Citation Reports 2025
2.5
Citescore
CiteScore measures average citations received per document published.
5.3
SJR
SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.
0.707
SNIP
SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.
1.023
Time to first decision
The median number of days it takes for an article to go from submission to first editorial decision.
7 days
Ana T. A. Oliveiraa, Carlos A. Longuib, Eduardo A. Feronec, Fábio S. Kawagutid, Osmar Montee, Luis Eduardo P. Calliarif
a Residente de 4o ano da Unidade de Endocrinologia Pediátrica, Dep. de Pediatria e Puericultura - Santa Casa de Misericórdia de São Paulo, DPP/SCMSP.
b Professor Assistente-Doutor, Departamento de Pediatria da Fac. de Ciências Médicas Santa Casa de São Paulo.
c Quintanista da Faculdade de Ciências Médicas da Santa Casa da São Paulo.
d Quintanista da Faculdade de Ciências Médicas da Santa Casa de São Paulo.
e Chefe da Unidade de Endocrinologia Pediátrica - DPP/SCMSP.
f Professor assistente do Depto. Pediatria - Unidade de Endocrinologia Pediátrica - Faculdade de Ciências Médicas da Santa Casa de São Paulo.
Abstract
Objective
to determine the thyroid stimulating hormone (TSH) secretion in children with Down syndrome (DS), who do not present clinical and laboratory evidence of classical hypothyroidism and concomitant undetectable antibodies.
Methods
fourteen children with DS with a mean age of 3.4 (±1.8) years were studied. Patients with classical hypothyroidism or hyperthyroidism or those with positive antithyroid antibodies were excluded. The DS group was compared to a control group of 16 children with a mean age of 11.8 (±3.8) years, diagnosed as having familial short stature or constitutional growth delay. Both groups underwent hormonal measurements at basal condition to determine serum TSH, T3, T4, free T4 and prolactin concentrations and after stimulation with thyrotropin releasing hormone (TRH). Thyroid hormones concentrations were also compared when children with DS were subdivided into two groups according to their basal TSH levels.
Results
basal TSH and prolactin levels were significantly higher in DS group. After stimulation with TRH, TSH peak was higher in the DS group. The number of patients presenting basal TSH levels higher than 5 μU/mL and TSH peaks higher than 30 μU/mL were significantly higher in the DS group.
Conclusions
children with Down syndrome present frequent increase in basal TSH concentrations, despite the presence of normal basal thyroid hormones levels and negative antithyroid antibodies. Most of them (65%) show early intense response after TRH stimulation. Our data demonstrate that in spite of the absence of classic hypothyroidism and/or antithyroid antibodies, an abnormal pattern of TSH secretion occurred in patients with Down syndrome, possibly related to hypothalamic dysfunction.
Resumen
Objetivo
determinar a secreção de TSH em crianças com síndrome de Down, sem quadro clínico-laboratorial clássico de hipotireoidismo.
Métodos
analisou-se 14 crianças com síndrome de Down e idade média de 3,4 (±1,8) anos. Excluiu-se pacientes com sintomas clássicos de hipotireoidismo ou hipertireoidismo, ou que apresentassem anticorpos antitireóide positivos. Os pacientes foram comparados a um grupo controle de 16 pacientes com idade média de 11,8 (±3,8) anos e diagnóstico de baixa estatura familial ou atraso constitucional do crescimento. Foram determinadas as concentrações de TSH, T3, T4, T4L e prolactina no tempo basal e após estímulo com TRH. Pacientes com síndrome de Down, subdivididos quanto ao TSH basal, foram comparados em relação às concentrações basais de T3, T4, T4L e prolactina.
Resultados
os valores basais de TSH e de prolactina foram significativamente maiores no grupo com síndrome de Down. Após estímulo com TRH, o pico de TSH foi maior no grupo com síndrome de Down. Tanto o número de pacientes com TSH basal > 5 μU/ml, quanto o número dos que apresentaram hiper-resposta ao estímulo com TRH (pico de TSH > 30 μU/ml), foi maior no grupo com síndrome de Down.
Conclusões
freqüentemente, crianças portadoras de síndrome de Down apresentam elevação do TSH basal, mesmo na presença de valores basais normais de hormônios tireoidianos e anticorpos antitireóide negativos. A maioria dessas crianças (65%) apresenta hiper-resposta ao teste de estímulo com TRH. Nossos achados demonstram que nem todas as crianças com síndrome de Down e TSH elevado apresentam quadro clássico de hipotireoidismo, sugerindo nesses pacientes uma secreção anômala de TSH de origem hipotalâmica.
Full text is only available in PDF