Assessment of thyroid function in children and adolescents with chronic liver diseases

Abstract

Introduction The majority of hepatic patients are clinically euthyroid. However, liver disorders may alter thyroid hormone metabolism, including substantial abnormalities of either euthyroid sick syndrome (ESS), autoimmune thyroid disorders, or subclinical hypothyroidism (SH). But there are few studies conducted on children with chronic liver diseases (CLD) to assess thyroid functions. Aim The study aimed to evaluate thyroid profiles in patients with CLD. Patients and methods An observational, cross-sectional study including patients with CLD attending Hepatology Clinic at Alexandria University Children’s Hospital from June 2021 to June 2022. One hundred and two children were included and a history taking and clinical examination were performed. Assessment of severity using a modified Child–Pugh score was done. Laboratory investigations in the form of liver, lipid, and thyroid profiles were done. Results One hundred and two children with CLD were included in this study, 50 (49.0%) females and 52 (51.0%) males. The most common diagnosis in the studied cases was autoimmune hepatitis (24.5%), followed by glycogen storage disease. Out of 14 (13.7%) aberrant outcomes of thyroid function, seven (6.9%) patients had ESS, and seven (6.9%) individuals had SH. By univariate analysis, alkaline phosphatase and serum albumin level were significant risk factors for SH. Furthermore, melena and hepatic encephalopathy were significant risk factors for ESS. Conclusion Thyroid dysfunction might occur in CLDs either in the form of SH or ESS. The prevalence of thyroid disease in children with CLD exceeded 10%, which signifies the importance of screening for thyroid dysfunctions in this cohort.