CARDIAC ABNORMALITIES IN CHILDREN WITH DOWN SYNDROME AND THYROID DYSFUNCTIONS

Abstract

Summary T his study aimed to evaluate cardiac functions inrelation to the thyroid profile in patients with DS. The study included 100 consecutive patients with DS from the Genetics Unit, Children’s Hospital-Ain Shams University, their ages ranged between 9 months and 264 months. Blood samples were collected under complete aseptic conditions to measure free T4, TSH levels and thyroid antibodies (anti-thyroglobulin and anti-peroxidase) using standardized laboratory techniques. We used M mode,2D,colour pulsed, continuous wave Doppler and tissue Doppler echocardiography for evaluation of cardiac chamber size, valvular, the presence of congenital cardiac abnormalities, pulmonary pressure, systolic(EF,Sm, ST) and diastolic(Em, Am,Em /Am,ET, AT, ET/AT) functions assessment using (Vivid E9 machine, Vingmed Horton, Norway). Our study revealed that subclinical hypothyroidism was found in 8 patients (8%). Thyroid antibodies were positive in one patient (only anti-thyroglobulin was positive) while anti-peroxidase was negative in all patients. None of the patients had overt hypothyroidism or overt hyperthyroidism. In this study, 73% of DS patients had congenital heart diseases. VSD was the commonest (56.16%) Followed by ASD (52.05%), PDA (13.70%) and the least was AV canal which was found in 8 patients (10.96%). No statistically significant difference between male and female as regard TSH. There was no statistically significant difference was found between patients with normal and congenital heart disease regarding thyroid profile levels. Our study revealed that nine patients had pericardial effusion, 8 of them had mild and one had moderate pericardial effusion. All of these patients had normal free T4 and TSH and 7 patients had CHD while two patients had not. There was no statistically significant difference was found between patients with and without pericardial effusion as regarding thyroid profile levels. In this study eleven patients (11%) had mild pulmonary hypertension,31% had moderate pulmonary hypertension and 58% had normal pulmonary pressure. All of the eleven patients except one had CHD. There was no statistically significant difference was found between patients with and without pulmonary hypertension regarding thyroid profile.