Subclinical hypothyroidism in children with Down syndrome: To treat or not to treat???

In general, hyperthyrotropinemia and whether to treat or not, is still an unresolved issue. There are no clear guidelines. Elevated TSH at screening, even when of very short duration, may be a clinically relevant marker of thyroid abnormalities [1]. Data from the Italian National Registry of Infants with Congenital Hypothyroidism reported an association between defects of thyroid development and mild increase of b-TSH at screening. Specifically, 19.6% of babies with a mild increase of b-TSH at screening had defects of thyroid development (thyroid hypoplasia, hemiagenesis, and ectopy) [2].