Age-related patterns of thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation in Down syndrome

Article Abstract:

Several aspects of thyroid function are known to be abnormal in children with Down syndrome (trisomy 21, a genetic disorder); to learn more about this issue, a study of 47 children and infants with this disorder was undertaken. The subjects' ages ranged from one month to seven years. They were examined in the fasting state for their responses to an injection of thyrotropin-releasing hormone (TRH), which normally stimulates the secretion of thyroid-stimulating hormone (TSH; also called thyrotropin) by the pituitary gland (the master endocrine gland). TSH, in turn, stimulates the cells in the thyroid gland to produce thyroid hormones (T3 and T4), which have a range of physiological effects. Measurements were made of the blood levels of these hormones at regular intervals after injection in Down syndrome subjects and in 22 age-matched control subjects. Results from the 33 Down syndrome subjects who underwent only one TRH test showed that the levels of T3 and T4 were similar in both groups. However, the basal (baseline) TSH level and the peak TSH response (the highest value obtained after the TRH injection) were generally higher for Down syndrome than control subjects. This was also true for the TSH level one hour after injection. These trends were similar at all ages studied. For 14 Down syndrome patients whose responses to the initial TRH test were abnormal, basal and peak TSH levels were higher in younger Down syndrome children than older. This elevation was not present in older children. While the Down syndrome patients did not have hypothyroidism (inadequate thyroid secretion), they did have higher TSH levels than those normally associated with the levels of T3 and T4 they produced. This could be a sign of immaturity of the hypothalamic-pituitary system, which regulates a number of physiological processes in the body. It may be worthwhile to administer thyroid supplementation in such cases, but additional study is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Development and progression, Demographic aspects, Down syndrome, Thyroid hormones, Thyroid diseases, Thyroid gland function tests, Thyroid function tests

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Rhabdomyoma and ventricular preexcitation syndrome: a report of two cases and review of literature

Article Abstract:

Cardiac tumors should not be ruled out in children with irregular heartbeat. Rhabdomyomas are benign tumors often found in the heart, pancreas, kidneys or brain. At a children's hospital in Philadelphia, two newborns with ventricular preexcitation syndrome were found to have cardiac rhabdomyomas. The tumors can cause death by obstructing blood flow through the heart or by causing disruptions in the normal heartbeat. On X-ray examination, one child's heart appeared normal, the other had evidence of decreased blood flow through her lungs. Open heart surgery on the child with restricted blood flow found a tumor beginning in her right atrium, extending through the tricuspid valve to the right ventricular cavity. Emergency surgery on the second child revealed a tumor obstructing the left ventricular outflow. On admission, both children had evidence of ventricular preexcitation syndrome and one also had supraventricular tachycardia.

Case studies, Diagnosis, Arrhythmia, Arrhythmia in children, Pediatric cardiology, Tumors in children, Pediatric tumors, Cardiovascular tumors, Vascular tissue tumors

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