Abstract
Subclinical hypothyroidism (SH) is characterized by mildly elevated thyroid stimulating hormone (TSH) levels with normal serum-free thyroxine (fT4). While the prevalence of SH is 2 % in pediatric population, it has been reported much higher in children with migraine headache. In this study, the presence of subclinical hypothyroidism and associated endocrinological abnormalities in children with migraine naïve to treatment was investigated. Children with migraine who were diagnosed in Pediatric Neurology Clinic based on the second edition of the International Classification of Headache Disorders and who did not receive any medication were recruited in this cross-sectional study. All patients were examined by the same pediatric endocrinologist and anthropometric measurements, systemic blood pressure, pubertal stages were recorded. Fasting serum levels of thyroid function tests, lipids, glucose and insulin were obtained. Ninety-eight children (55 female) with a mean age of 11.45 ± 3.1 years were evaluated. Of those, 39 were prepubertal and 59 were pubertal. Subclinical hypothyroidism (TSH ≥ 5.0 mIU/L with normal fT4) was detected in five patients (5.1 %); none had positive thyroid antibodies. Other conditions were obesity (n = 6), hirsutism (n = 4), short stature (n = 3), polycystic ovaries (PCO, n = 3), precocious puberty (n = 2) and gynecomastia (n = 1). Of five patients with SH, only one had obesity. Our results revealed that the prevalence of SH in children with migraine is not as high as previously reported. Since no significant endocrinologic disturbance was found in those children, we suggest that the initial endocrinological evaluation or screening for SH is unnecessary.
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References
Split W, Neuman W (1999) Epidemiology of migraine among students from randomly selected secondary schools in Lodz. Headache 39:494–501
Petersen S, Hägglöf BL, Bergström EI (2009) Impaired health-related quality of life in children with recurrent pain. Pediatrics 124(4):e759–e767
Lateef T, Cui L, Heaton L, Nakamura EF, Ding J, Ahmed S, Merikangas KR (2013) Validation of a migraine interview for children and adolescents. Pediatrics 131(1):e96–e102
Wu T, Flowers JW, Tudiver F, Wilson JL, Punyasavatsut N (2006) Subclinical thyroid disorders and cognitive performance among adolescents in the United States. BMC Pediatr 6:12
Rapa A, Monzani A, Moia S, Vivenza D, Bellone S, Petri A, Teofoli F, Cassio A, Cesaretti G, Corrias A, de Sanctis V, Di Maio S, Volta C, Wasniewska M, Tatò L, Bona G (2009) Subclinical hypothyroidism in children and adolescents: a wide range of clinical, biochemical, and genetic factors involved. J Clin Endocrinol Metab 94(7):2414–2420
Marwaha RK, Tandon N, Garg MK, Ganie MA, Narang A, Mehan N, Bhadra K (2013) Impact of body mass index on thyroid functions in Indian children. Clin Endocrinol (Oxf). 79(3):424–428
Kaplowitz PB (2010) Subclinical hypothyroidism in children: Normal variation or sign of a failing thyroid gland? Int J Pediatr Endocrinol 2010:281453
Bona G, Prodam F, Monzani A (2013) Subclinical hypothyroidism in children: natural history and when to treat. J Clin Res Pediatr Endocrinol. 5(Suppl 1):23–28
Fallah R, Mirouliaei M, Bashardoost N, Partovee M (2012) Frequency of subclinical hypothyroidism in 5- to 15-year-old children with migraine headache. J Pediatr Endocrinol Metab 25(9–10):859–862
Marshall WA, Tanner JM (1969) Variations in pattern of pubertal changes in girls. Arch Dis Child 44:291–303
Marshall WA, Tanner JM (1970) Variations in the pattern of pubertal changes in boys. Arch Dis Child 45:13–23
Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419
Mirouliaei M, Fallah R, Partovee M, Ordooei M (2012) Efficacy of levothyroxine in migraine headaches in children with subclinical hypothyroidism. Iran J Child Neurol 6(4):23–26
Iwasaki Y, Kinoshita M, Ikeda K, Takamiya K, Shiojima T (1991) Thyroid function in patients with chronic headache. Int J Neurosci 57:263–267
Toprak D, Demirkukan K, Ellidokuz H (2007) Is it important to test thyroid function tests in migraineurs? TJFMPC 4:47–51
Lisotto C, Mainardi F, Maggioni F, Zanchin G (2013) The comorbidity between migraine and hypothyroidism. J Headache Pain 14(Supp 1):P138
Hagen K, Bjoro T, Zwart J-A, Vatten L, Stovner LJ, Bowim G (2001) Low headache prevalence amongst women with high TSH values. Eur J Neurol 8:693–699
Ramadan NM, Scultz LL, Gilkey SJ (1997) Migraine prophylactic drugs: proof of efficacy, utilization and cost. Cephalalgia 17:73–80
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Ekici, B., Cebeci, A.N. The debate on the link between subclinical hypothyroidism and childhood migraine: is initial endocrinological evaluation necessary for children with migraine?. Acta Neurol Belg 115, 123–127 (2015). https://doi.org/10.1007/s13760-014-0340-9
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DOI: https://doi.org/10.1007/s13760-014-0340-9