srjcmsSRJCMSSRJCMS2788-885110.47310/srjcms.2024.v04.i02.022Pediatric Subclinical Hypothyroidism: An Analysis of Demographics, Autoantibodies, and Thyroid FunctionAmalAdnanRasheed LaylaniHussainAlsaffarConsultant pediatrician, Kirkuk Health Directorate, Iraq.Pediatric endocrine and diabetes unit, Child health department , Sultan Qaboos university hospitalBackground: Subclinical hypothyroidism (sHT) is defined by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroxine (FT4) levels, occurring without overt symptoms of thyroid dysfunctionAim: The aim was to investigate the demographic properties, risk factors, presence of thyroid autoantibodies, and thyroid function tests among children under age of 10 years who received their follow up at Azadi hospital.Materials and Methods: A cross-sectional study was conducted between January and December 2023 at Azadi Teaching Hospital in Kirkuk City, Iraq. The study included 104 children under 10 years diagnosed with sHT based on elevated TSH levels and normal FT4 levels, recruited from the pediatric endocrinology clinic. A control group of 50 healthy children was also included. Children with overt hypothyroidism, on thyroid medications, or with chronic illnesses affecting thyroid function were excluded. Data collection involved demographic, clinical, and laboratory parameters, including TSH, FT4, thyroglobulin antibodies, and thyroid peroxidase antibodies measured using immunoassay and ELISA methods. The study received approval from the Ethics Committee of Azadi Teaching Hospital and ensured the preservation of anonymity and privacy.Results: The analysis revealed that children aged 1-5 years were the most affected group (34.6%), followed by infants (30.8%). A slight female predominance was noted (53.9%). A family history of thyroid disorders was present in 46.2% of cases, and 15.4% had trisomy 21 syndrome, highlighting the significance of possible genetic and syndromic risk factors. Importantly, 50% of children with sHT tested positive for thyroglobulin antibodies, and 38.46% had thyroid peroxidase antibodies, compared to 0% in the control group (p = 0.001 for both), indicating a strong association between sHT and autoimmunity. All children with sHT had elevated TSH levels, while TSH remained within the normal range for all controls (p = 0.001). The study found that children with a family history of thyroid disorders are more likely to have symptoms such as fatigue, cold intolerance, and constipation, indicating a strong association between these conditions and the presence of thyroid autoantibodies Conclusion: The findings highlight the critical roles of genetic predisposition, the presence of thyroid autoantibodies, and the pivotal role of TSH in the diagnostic process. These results underscore the need for practical guidelines for clinicians managing pediatric patients with subclinical hypothyroidism, particularly in identifying at-risk individuals and making informed decisions regarding monitoring and potential treatment strategies.