Thyroid function screening and follow-up of children with abdominal distension in Nanjing, China: a cross-sectional study

BMJ Open. 2023 Jan 25;13(1):e070416. doi: 10.1136/bmjopen-2022-070416.

Abstract

Objective: To describe the thyroid function test among children with abdominal distention and to follow up the treatment received by children with abnormal thyroid function.

Design: Cross-sectional study.

Setting and participants: A total of 1089 children (median age:30 days (IQR=21-60 days) with abdominal distension were included in this single centre study in Nanjing, China.

Result: Thyroid dysfunction was found in 43 of 148 Hirschsprung's disease (HSCR) cases, with 3 (2.03%) having hypothyroidism, 3 (2.03%) having subclinical hypothyroidism and 3 (2.03%) having subclinical hyperthyroidism. Thyroid dysfunction was found in 206 of 941 functional abdominal distension cases, with 4 (0.43%) having hypothyroidism, 23 (2.4%) having subclinical hypothyroidism, 28 (2.9%) having subclinical hyperthyroidism and 1 (0.11%) having hyperthyroidism. Among total 65 cases (9 from HSCR, 56 from functional abdominal distension) diagnosed with thyroid diseases, 12 were treated with levothyroxine (LT-4), of which 9 were discontinued treatment at about 2 years old, and 3 were still receiving LT-4. Thirty-two cases received no treatment and thyroid function returned to normal in about 1 month. Twenty-one cases were lost during the follow-up.

Conclusion: The paediatrician should be vigilant for hypothyroidism when dealing with children with abdominal distension. Thyroid function should be followed up rather than simply administering a short-term levothyroxine treatment.

Keywords: functional bowel disorders; paediatric endocrinology; paediatric gastroenterology; thyroid disease.

MeSH terms

  • Child
  • Child, Preschool
  • China / epidemiology
  • Cross-Sectional Studies
  • Digestive System Abnormalities*
  • Follow-Up Studies
  • Humans
  • Hyperthyroidism* / complications
  • Hyperthyroidism* / diagnosis
  • Hyperthyroidism* / drug therapy
  • Hypothyroidism* / complications
  • Hypothyroidism* / diagnosis
  • Hypothyroidism* / drug therapy
  • Infant
  • Thyroid Diseases*
  • Thyroxine / therapeutic use

Substances

  • Thyroxine