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Forum Name: Pediatric Topics

Question: Infant TSH level of 438!!!!!


 thecashmama - Sat Nov 06, 2004 3:28 pm

We recently had our daughter Caroline who has down syndrome tested for thyroid. Her levels came back as TSH over 438, and T4 was less than a 1. We had a thyroid scan done on Tuesday that showed no thyroid gland, but they said since she has been on synthroid .0375 a day for 10 days it would have some effect on the results of the scan. I was just wondering how long would someone have to go with out the thyroid hormone to get a TSH level of 438? Caroline just turned 11 months old.
 Dr. Heba Ismail - Sun Nov 14, 2004 8:58 am

Dear thecashmama,
Children with Down's syndrome are always at increased risk for the development of a decrease in thyroid gland function (hypothyroidism) of the autoimmune type, where the body starts to attack the thyroid gland and eventually destroys it.
Now any patient suffering hypothyroidism, with a defect primarily in the thyroid gland, would have an expected TSH level of > 100mU/L.
Diagnosis may be delayed in children with Down's syndrome, in spite of the high index of suspicion, because they share many of the manifestations with those suffering hypothyroidism.
Even patients with a congenitally absent thyroid may show no symptoms at birth and also suffer a delay in diagnosis, as some of the mother's thyroxine (T4) passes through the placenta to her fetus. Symptoms of hypothyroidism often appear gradually, and diagnosis is usually at the age of 3-6 months, when the clinical picture is fully developed.

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