Document Type : Original Article
Authors
1
Department of Pediatric, Endocinology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2
Ministry of health hospitals, Kafr El-shiekh, Egypt.
3
Department of pediatric, Hepatology Unit, Faculty Ain Shams University, Cairo, Egypt
4
Clinical Pathology Department, Faculty of medicine, Ain Shams University, Cairo, Egypt
5
Department of Pediatrics, Endocinology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Thyroid hormone metabolism may be impaired in chronic liver diseases. Non-thyroidal illness (NTIS) or subclinical hypothyroidism (SH) or even overt hypothyroidism may occur.
Aim of the Work: To assess thyroid gland status in children and adolescents with chronic liver diseases (CLD).
Methods: This cross- sectional controlled study was conducted on 40 children with chronic liver diseases recruited from Pediatric Hepatology Clinic, Children’s Hospital, Ain-Shams University and compared to 40 age- and sex- matched healthy controls. History taking and physical examination were performed. Assessment of severity using modified Child-Pugh score was done. Laboratory investigations in the form of liver functions and thyroid profiles were done.
Results: Twenty males (50%) and twenty females (50%) were included in the study. 67.5% of patients with CLD had non-cholestatic liver diseases. Biliary atresia and congenital hepatic fibrosis were the most frequent causes of CLD. About 75 % and 22.5 % of the patients had Child-Pugh A and B cirrhosis respectively. Normal thyroid function was detected in 95% of cases, while 5% had subclinical hypothyroidism despite most of our cases were euthyroid, they had significantly lower T3 (p< 0.001) and higher TSH levels (p < 0.017). TSH was significantly higher in group of patients with Child-Pugh B/C class. Free T3 had significant negative correlation with total bilirubin. TSH had significant positive correlations with total and direct bilirubin.
Conclusion: Thyroid dysfunction might occur in children with CLDs. Children with CLD demonstrated an increase in TSH levels. Thus, screening of thyroid function is recommended when investigating patients with CLD.
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