Subclinical hypothyroidism in children

Abstract

Roentgen ray and blood serum cholesterol studies were made on over 500 boys committed to a corrective institution. Basal metabolism tests were made on those boys with retarded osseous development and on those with high serum cholesterol findings. A small group of boys with retarded osseous development and without other endocrine dysfunctions were studied in detail and correlations were made with their mental level, school achievement and behavior. The results of our study were checked against the opinions of 11 outstanding endocrinologists that were obtained, by the questionaire method. The results of our study in consonance with the opinions of others indicates that osseous retardation is the most consistent finding in hypothyroidism in children. Basal metabolism and serum cholesterol findings are of little aid in the diagnosis in children, because of variability and lack of consistent relationship to the clinical pictures. In the clinical picture only dryness of the skin and the brittleness of the hair were consistently found. A history of overweight at birth and a delay in development such as teething, walking and talking, is of corroborative significance. The intelligence is not a reliable criterion; some hypothyroid children are bright and some retarded. The behavior was found to be either hypoactive or hyperactive hence of little aid in the diagnosis. Subclinical types of hypothyroidism may be recognized by the osseous retardation, as revealed by x-ray, and by the favorable reaction of the patient to replacement therapy with thyroid gland substance. © 1936 by The Endocrine Society.