Thyroid function screening and follow-up of children with abdominal distension in Nanjing, China: a cross-sectional study

OBJECTIVE: To describe the thyroid function test among children with abdominal distention and to follow up the treatment received by children with abnormal thyroid function. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 1089 children (median age:30 days (IQR=21–60 days) with abdominal distension were included in this single centre study in Nanjing, China. RESULT: Thyroid dysfunction was found in 43 of 148 Hirschsprung’s disease (HSCR) cases, with 3 (2.03%) having hypothyroidism, 3 (2.03%) having subclinical hypothyroidism and 3 (2.03%) having subclinical hyperthyroidism. Thyroid dysfunction was found in 206 of 941 functional abdominal distension cases, with 4 (0.43%) having hypothyroidism, 23 (2.4%) having subclinical hypothyroidism, 28 (2.9%) having subclinical hyperthyroidism and 1 (0.11%) having hyperthyroidism. Among total 65 cases (9 from HSCR, 56 from functional abdominal distension) diagnosed with thyroid diseases, 12 were treated with levothyroxine (LT-4), of which 9 were discontinued treatment at about 2 years old, and 3 were still receiving LT-4. Thirty-two cases received no treatment and thyroid function returned to normal in about 1 month. Twenty-one cases were lost during the follow-up. CONCLUSION: The paediatrician should be vigilant for hypothyroidism when dealing with children with abdominal distension. Thyroid function should be followed up rather than simply administering a short-term levothyroxine treatment.