Keypoints thyroid. 16.03.00


                                               DOWN'S SYNDROME
                                     THYROID DYSFUNCTION
                                                                           Key points

     (Based on DSMIG guidelines for basic essential medical surveillance)

     Hypothyroidism affects 10-20% of people with
     Down's syndrome. It can occur at any age.
     Clinical diagnosis is difficult. Screening blood
     tests are essential. It can be successfully treated. If
     untreated it causes severe preventable handicap.

        Neonatal screen followed by either:

        Venous blood screen: - T4, TSH, and thyroid antibodies
        checked at age 1 and thereafter every 2 years for life. If
        normal T4 but mildly raised TSH or antibodies check
        more frequently or:

        Finger prick capillary blood screen ­ annual Guthrie
        TSH check. All with Guthrie TSH > 10mU/l  to be
        referred for venous sampling

        Whatever the results of screening tests clinicians to
        have a low threshold for testing if clinical suspicion at
        any time.

        Clinical pointers as in general population: - lethargy
        and/or changes in affect, cognition, growth and weight

        Differential diagnosis from depression and dementia
        critically important

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DSMIG (UK) 2001   www.dsmig.org.uk                                                                                                                                      16.01.02