96
- What are the height prospects in children with juvenile hypothyroidism?
Early diagnosis and optimal replacement therapy result in attainment of nor-
mal fi nal adult height in children with juvenile hypothyroidism. Children
with long-standing hypothyroidism will experience catch-up growth after
initiation of L-thyroxine; however, catch-up growth is often incomplete in
these patients due to diminished chondrocyte reserve. Children in the peripu-
bertal age and those who are overzealously treated with L-thyroxine may
experience rapid skeletal maturation and, hence, compromised fi nal adult
height. There are a few case studies where GnRH analogue has been used
with or without rhGH in children with juvenile hypothyroidism during peri-
pubertal period who had suboptimal catch- up growth. However, the results
were variable (Fig. 3.17 ).
a bb
cc
Fig. 3.16 ( a ) A 10-year-old boy with overt features of hypothyroidism. ( b ) Coronal and ( c ) sagit-
tal T1W images showing presence of diffuse homogenous enlargement of the pituitary gland ( red
arrow ) suggestive of pituitary hyperplasia (thyro-lactotrope) in the same patient
3 Thyroid Disorders in Children