Refractory hypothyroidism in children: an overview.

Refractory hypothyroidism (RF) defined as raised serum levels of thyroid stimulating hormone (TSH) above upper limit of the reference range with or without the persistence of hypothyroid symptoms following a 6-week interval after the dosage was last increased to upper limits of dose per age. The most common cause of RH is inadequate compliance. In addition, diet, concomitant medication interactions, and gastrointestinal diseases can all result in l-thyroxine (LT4) malabsorption, which can cause RH. Moreover, weight gain, switching brands of LT4, poor storage of LT4, chronic liver disorders, cystic fibrosis, nephrotic syndrome, consumptive hypothyroidism, Addison's disease are significant contributors to RF in children. RH in children is frequently asymptomatic, when symptoms do occur, they are typically minor and resemble those of hypothyroidism. It is essential to identify RH early and treat its underlying cause in order to avoid overusing LT4, which can lead to cardiac and bone problems. Endocrinologists should handle children who they suspect of having RH methodically after making sure there is enough compliance. Searching for undiagnosed illnesses and/or other factors that can affect LT4 absorption could be part of this. We present this review after an extensive literature search and long-standing clinical experience. This review's objective is to shed light on the causes, clinical manifestations, investigations, and treatment of RH in children.

Metwalley KA ，Farghaly HS 《-》

Refractory hypothyroidism.

Lai YY ，Thambiah SC ，Mohamed Mokhtar N ，Samsudin IN ... -  《Malaysian Journal of Pathology》

ITALIAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS STATEMENT-REPLACEMENT THERAPY FOR PRIMARY HYPOTHYROIDISM: A BRIEF GUIDE FOR CLINICAL PRACTICE.

Guglielmi R ，Frasoldati A ，Zini M ，Grimaldi F ，Gharib H ，Garber JR ，Papini E ... -  《Endocrine Practice》

Refractory Hypothyroidism: Unraveling the Complexities of Diagnosis and Management.

Quiroz-Aldave JE ，Concepción-Zavaleta MJ ，Durand-Vásquez MDC ，Concepción-Urteaga LA ，Gamarra-Osorio ER ，Suárez-Rojas J ，Rafael-Robles LDP ，Paz-Ibarra J ，Román-González A ... -  《Endocrine Practice》

Liquid levothyroxine improves thyroid control in patients with different hypothyroidism aetiology and variable adherence - case series and review.

Ruchała M ，Bossowski A ，Brzozka MM ，Gietka-Czernel M ，Hubalewska-Dydejczyk A ，Kos-Kudła B ，Lewiński A ，Syrenicz A ，Zgliczyński W ... -  《-》