Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2016; 5(3): 306-310
Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.306
Subclinical hypothyroidism in atopic South Italian children
Marcella Pedullà, Vincenzo Fierro, Pierluigi Marzuillo, Ester Del Tufo, Anna Grandone, Laura Perrone, Emanuele Miraglia del Giudice
Marcella Pedullà, Vincenzo Fierro, Pierluigi Marzuillo, Ester Del Tufo, Anna Grandone, Laura Perrone, Emanuele Miraglia del Giudice, Department of Woman, Child and General and Specialized Surgery, Seconda Università degli Studi di Napoli, 80138 Napoli, Italy
Author contributions: Pedullà M drafted the manuscript; Pedullà M, Fierro V and Marzuillo P participated in the conception and the design of the study; Del Tufo E and Grandone A examined the patients, collected anthropometric data; Perrone L and Miraglia del Giudice E supervised the design and execution of the study.
Institutional review board statement: The approved protocol from the Institutional Review Board at the Second University of Naples.
Informed consent statement: An informed consent was obtained from the parents and the children all enrolled after the nature of the investigation was explained.
Conflict-of-interest statement: The authors have nothing to declare.
Data sharing statement: We agree with data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pierluigi Marzuillo, MD, Department of Woman, Child and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Via L. De Crecchio n° 2, 80138 Napoli, Italy. pierluigi.marzuillo@gmail.com
Telephone: +39-081-5665420 Fax: +39-081-5665427
Received: March 1, 2016
Peer-review started: March 1, 2016
First decision: March 22, 2016
Revised: March 29, 2016
Accepted: April 14, 2016
Article in press: April 18, 2016
Published online: August 8, 2016
Abstract

AIM: To verify if subclinical hypothyroidism (SCH) could be associated to atopy in children.

METHODS: Seven hundred and thirty-two Caucasian children from South Italy presenting symptoms of allergic disease were enrolled and submitted to atopy, obesity, chronic low grade inflammation, and SCH work up.

RESULTS: Four hundred and forty-five out of 705 (63.12%) children affected by allergic disease were diagnosed as atopic and 260 (36.88%) as not atopic. The SCH prevalence was 6.3%. Significant higher prevalence of SCH among atopic children with average (group 2) and high (group 3) low grade chronic inflammation compared to atopic children with mild (group 1) low grade chronic inflammation was present. Moreover, group 1 and group 2 presented an OR to show SCH of 2.57 (95%CI: 1.55-6.26) and 2.96 (95%CI: 1.01-8.65), respectively. Both in atopic and not atopic children we found C3 serum levels significantly higher in group 3 respect to group 2 and group 1. Noteworthy, among atopic patients, also total immunoglobulin E (IgE) serum levels, were significantly higher in group 3 compared to group 2 and group 1 children. In atopic children, C3 and total IgE serum values increased in parallel with the increase of C-reactive protein values, while in not atopic children this phenomenon was not evident.

CONCLUSION: The possibility exists that an increasing atopic inflammation contributes to SCH occurrence. So far this is the first report in literature showing an association between SCH and atopy but further studies are needed to confirm our data.

Keywords: Thyroid derangement, Atopy, Children, Low grade chronic inflammation, Subclinical hypothyroidism

Core tip: A high subclinical hypothyroidism (SCH) prevalence has been associated in childhood to obesity and the chronic low grade inflammation found obese children has been involved in this relationship. In our population, obesity does not influence SCH prevalence. Interestingly, we found a SCH prevalence twice higher compared to all other patients and a significant higher risk to show SCH in atopic children affected by the highest C-reactive protein values characterizing low-grade inflammation.