Spectrum of pediatric thyroid disorders: Clinic-based data from Northern India

ABSTRACT Background: The prevalence and etiology of pediatric thyroid disorders vary across regions, influenced by genetic, environmental, and nutritional factors. There is limited data on the spectrum of thyroid disorders in Indian children. Aims and Objectives: We aimed to analyze the distribution and causes of thyroid disorders attending a pediatric thyroid clinic in Northern India over the last decade. Methods: A retrospective review of medical records was conducted for children (≤12 years) registered in the thyroid clinic between January 2015 and December 2024. Thyroid disorders were classified based on diagnostic criteria, including biochemical, serological, and imaging assessments. Results: Of the 542 children included in the study, the median age at presentation was 8 years (interquartile range 2–10 years), with a higher proportion of females (59%). Acquired hypothyroidism (64.6%) was the most frequently observed disorder, with autoimmune thyroiditis (55%) as the primary cause. Nonautoimmune acquired hypothyroidism ( n = 157) included cases of central hypothyroidism, thyroid malignancy, and obesity-associated thyroid dysfunction. Congenital hypothyroidism (CH) (31%) was largely attributed to thyroid dysgenesis and dyshormonogenesis, though a significant number of cases remained idiopathic. Hyperthyroidism (4.8%) was uncommon, with most cases due to Graves’ disease. In addition, thyroid nodules (9%) and thyroid cysts (5%) were documented, predominantly in children with acquired hypothyroidism. Late diagnoses leading to Van Wyk–Grumbach syndrome were seen in eight cases. Comorbid conditions such as Down syndrome and celiac disease were also identified in a subset of patients. Conclusions: Acquired hypothyroidism, especially due to autoimmune thyroiditis, was the most common pediatric thyroid disorder, followed by CH. While hyperthyroidism was rare, it was almost exclusively due to Graves’ disease. The study underscores the need for early detection and comprehensive etiological assessment to improve outcomes in children with thyroid disorders.