ABSTRACT
Objective:To investigate whether interleukin(IL)-1β is involved in pyroptosis which leads to mouse islet β cell line βTC-6 cell damage, and to explore the role of JNK inhibitor SP600125 in inhibiting IL-1β induced βTC-6 cell pyroptosis.Methods:βTC-6 cell line and mouse islets were incubated with IL-1β for 48 h or intervened with both JNK inhibitor SP600125 and IL-1R antagonist IL-1Ra, then GSDMD expression and β cell pyroptosis morphology were detected by immunofluorescence staining of GSDMD and DAPI. The expression levels of Gsdmd, IL-1β and IL-18 mRNAs were detected by real time fluorescence PCR, and apoptosis was examined by Annexin-V/7-AAD staining combined with flow cytometry.Results:βTC-6 cell pyroptotic body was significantly increased in the IL-1β treated group compared with the control group, and the expressions of pyroptosis related genes Gsdmd, IL-1β, and IL-18 mRNA were significantly higher( P<0.05), and apoptosis was increased, suggesting that IL-1β effectively induced the βTC-6 cell pyroptosis, IL-1Ra prevented IL-1β induced βTC-6 cell pyroptosis. In the presence of JNK inhibitor SP600125, IL-1β treatment failed to induce the expressions of Gsdmd and IL-18 mRNA, markers of pyroptosis, and reduced the rate of apoptosis, indicating that SP600125 suppressed IL-1β induced βTC-6 cell pyroptosis. Conclusion:Pyroptosis is one of the mechanisms of βTC-6 cell impairment caused by IL-1β, and SP600125, a JNK inhibitor, can block the IL-1β induced pyroptosis pathway and has a potential role in inhibiting βTC-6 cell pyroptosis.
ABSTRACT
21-hydroxylase deficiency(21-OHD) is mainly characterized by cortisol deficiency with or without aldosterone deficiency and hyperandrogenemia.The disease requires lifelong exogenous glucocorticoid/salt supplementation.Excessive doses of exogenous glucocorticoids are often needed to control hyperandrogenemia, but the effect is not satisfactory.Corticotropin releasing factor (CRF) type 1 receptor antagonist can directly block the production of adrenocorticotropin, inhibit the generation of adrenogenic androgen, reduce the dose of glucocorticoid therapy, and thus lower the incidence of adverse reactions.In this article, the current research progress on 21-OHD therapy and CRF1 receptor antagonist was reviewed.
ABSTRACT
Nonketotic hyperglycinemia(NKH), also known as glycine encephalopathy, is a rare and life-threatening autosomal recessive disease.Due to the insufficient activity of the glycine cleavage enzyme system(GCS), glycine can not be degraded and accumulates in the body.It leads to progressive damage to the nervous system.The clinical manifestations of the disease vary.Based on ultimate outcome, NKH is categorized into severe NKH and attenuated NKH.It is characterized by increased glycine level in cerebrospinal, and further confirmatory tests are molecular genetic testing and enzymatic testing.So far, no causal treatment of NKH has been discovered and the overall prognosis is still poor.The therapy is based on sodium benzoate and N-methyl-D-aspartate(NMDA)receptor site antagonists.This article reviews the progress of NKH, in order to help clinicians comprehensively identify NKH and take proactive measures to get the best results.
ABSTRACT
Objective:To systematically evaluate the effects of oral stimulation combined with non-nutritional sucking on premature infants feeding.Methods:From the establishment of the databases to December 14, 2020, PubMed, Embase, Cochrane Library and SinoMed, CNKI, Wanfang databases were searched for randomized controlled trials (RCT) on oral stimulation combined with non-nutritive sucking in preterm infants. The gestational age (GA) of the infants was 26~37 w.The control group received routine nursing or sham treatment and the intervention group received oral stimulation and non-nutritional sucking on the basis of routine nursing. The intervention strategy included infant oral motor intervention and oral sensorimotor intervention. The literature were reviewed and the quality of RCTs evaluated. RevMan 5.3 software was used for meta-analysis.Results:A total of 20 RCTs were included, including 1 316 premature infants (GA 26~36 w). Compared with the control group, the intervention group had significantly shorter duration of hospital stay ( WMD=-3.45, 95% CI -4.41~-2.50, P<0.001). Significant differences existed in the corrected GA of discharge ( WMD=-0.68, 95% CI -1.10~-0.26, P=0.001), the age of total oral feeding(TOF) ( WMD=-5.22, 95% CI -9.04~-1.40, P=0.007), corrected GA of TOF ( WMD=-1.02, 95% CI -1.40~-0.64, P<0.001) and the body weight on TOF day ( WMD=-59.75, 95% CI -114.55~-4.95, P=0.030). Conclusions:Oral stimulation combined with non-nutritive sucking can accelerate TOF and shorten hospital stay in premature infants. The procedure should be standardized and promoted as routine and standard care for premature infants.
ABSTRACT
The hypothalamic-pituitary-thyroid axis gradually becomes mature at gestational age of 30~35 weeks.With the improvement of the treatment level of premature infants, the gestational age of surviving premature infants gradually decreases, and the thyroid axis of young premature infants is immature.Meanwhile, premature infants are more prone to systemic complications, such as ischemia and hypoxia, severe infection, etc., which aggravate the influence on thyroid.Clinically, more and more premature infants are found to be complicated with congenital hypothyroidism, temporary hypothyroxemia, hyperthyrotropin, delayed thyrotropin elevation, low T 3 syndrome and other problems.Abnormal thyroid function affects the outcome of the treatment of premature infant diseases.Early detection and early treatment is the key to improve the treatment, metabolism and the development of premature infant.At present, the timing of screening and treatment of premature thyroid disease is still controversial.In this review, the thyroid function and outcome of premature infants under different pathological conditions are summarized and analyzed to provide a reliable basis for rational selection of screening opportunities and treatment strategies for thyroid diseases in clinical practice.
ABSTRACT
Clinical data of a child with acromesomelic dysplasia Maroteaux type (AMDM) treated in the Department of Pediatrics, Tianjin Medical University General Hospital at November 2018 was retrospectively analyzed.The female child aged 3 years and 3 months old with 83 cm height (-3.84 SD) had clinical manifestations of disproportionate short stature, disproportionate shortening of forearms and forelegs, and stubby fingers and toes.Gene sequencing identified compound heterozygous mutations, c.1640T>A(p.Val547Asp)/c.682G>A(p.Gly228Ser), in the NPR2 gene, which have not been reported in the Human Gene Mutation Database.Their protein function was predicted harmful.The child was diagnosed as AMDM.During the follow-up until 4 years and 8 months old, the child was 90 cm tall (-4.35 SD), with a growth velocity of 4.9 cm/year.She was treated with recombinant human growth hormone (rhGH) treatment for 9 months and regularly followed up.The child was now 98.2 cm height (-3.07 SD) and she had a growth velocity of 10.9 cm/year.This case report enriched the gene mutation spectrum of AMDM.Treatment with rhGH can effectively improve the height of the child, but the long-term effect needs further follow-up and observation.
ABSTRACT
Nonketotic hyperglycinemia (NKH) is a rare congenital metabolic disorder with low diagnostic rate. This article reported a case of NKH caused by AMT gene mutation. The child started with suspected neonatal sepsis, and then the condition deteriorated rapidly, including apnea, hiccup, coma, convulsion, etc. Blood glucose, ketone body, blood gas analysis of electrolytes, blood ammonia and so on were generally normal. Blood and urine screening results showed that glycine was slightly higher, and the ratio of cerebrospinal fluid to serum glycine concentration increased. Electroencephalogram showed outburst suppression. High total exome sequencing results showed that the maternal exon 3 c.664C>T(p.Arg222Cys) of AMT gene was pathogenic, and the paternal exon 3 c.793C>T(p.Arg265Cys) was suspected to be pathogenic, which was an autosomal recessive genetic disease with complex heterozygosis. The clinical diagnosis and treatment of this child and the characteristics of gene mutation are summarized.
ABSTRACT
Nitric oxide is an endothelium-derived relaxing factor, which has the effect of dilating pulmonary vessels and reducing pulmonary artery pressure.Currently, inhaled nitric oxide has been widely used in the treatment of persistent pulmonary hypertension in term infants and late preterm infants, but its use in the field of preterm infants is still controversial.In recent years, there have been more and more studies on inhaled nitric oxide in premature infants.This review summarized the relevant studies at home and abroad in recent years, discussed the indications of inhaled nitric oxide in premature infants, and introduced the potential adverse reactions, in order to provide guidance for clinical work.
ABSTRACT
With the nationwide popularization of neonatal heel blood screening, and the change of screening standards and the improvement of premature infant survival rate, the incidence of congenital hypothyroidism in newborns has been increasing year by year.Some of these children need to take medication for all lifetime to maintain normal thyroid function, this is called persistent congenital hypothyroidism, while others don′t, is called transient congenital hypothyroidism.Causes of transient hypothyroidism include iodine deficiency, maternal thyrotrophin receptor blocker antibodies, maternal antithyroid medication, maternal or neonatal iodine exposure, premature delivery, and neonatal hepatic hemangioma.In this review, the author describes the etiology and management of children with transient hypothyroidism, meanwhile summarize several predictors of transient hypothyroidism.
ABSTRACT
Objective To study the diagnostic value of glycosylated hemoglobin(HbA1c)combined with ho-meostasis model assessment of insulin resistance( HOMA-IR)in obese children with prediabetes. Methods Five hundred and ninety-five obese children diagnosed at Outpatient Department of Pediatrics,Tianjin Medical University General Hospital were enrolled in the study from October 2012 to March 2016. Oral glucose tolerance test(OGTT)and HbA1c test were performed after fasting 8 to 10 hours for all the subjects. According to the World Health Organization (WHO)criteria,the obese children were divided into non-prediabetes group(483 cases)and prediabetes group(112 cases). The levels of HOMA-IR and HbA1c were compared between 2 groups. The receiver operating characteristic (ROC)curve was drawn for screening prediabetes,and the diagnosis value of area under curve( AUC)and different cutoff value were calculated. Logistic regression model was used to analyze the combined diagnosis of prediabetic AUC with preserved probability as a single variable and ROC curve. Z test was used to compare the statistical differences of each AUC. Results The levels of HbA1c and HOMA-IR of the prediabetes obese children group[(5. 65 ± 0. 36)%and 11. 60 ± 8. 86]were all higher than those of the non-prediabetes obese children group[(5. 47 ± 0. 32)% and 6. 49 ± 4. 61],and there were significant differences between 2 groups(all P<0. 01). The AUC of HbA1c ROC for prediabetes was 0. 633. When the cutoff was 5. 585%,the sensitivity and specificity were 0. 584 and 0. 601,respective-ly. The AUC of HOMA-IR ROC for prediabetes was 0. 758. When the cutoff was 7. 244,the sensitivity and specificity were 0. 779 and 0. 669,respectively. When combined with HOMA-IR and HbA1c,the AUC was 0. 764. Compared with HbA1c,there were significant differences in AUC of ROC curve between HOMA-IR alone or HOMA-IR com-bined with HbA1c in the diagnosis of prediabetes mellitus(all P<0. 01). There was no significant difference in AUC of ROC curve between HOMA-IR alone and HOMA-IR combined with HbA1c in the diagnosis of prediabetes melli-tus(P>0. 05). Conclusions Only HOMA-IR or HOMA-IR combined with HbA1c may be the optimal indexes for diagnosing obese children with prediabetes.
ABSTRACT
Objective@#To investigate whether rapid weight gain in the first year of life was associated with incidence of overweight and higher blood pressure in small for gestational age (SGA) and appropriate for gestational age (AGA) infants at preschool age.@*Methods@#From March 1, 2017 to June 30, 2018, a total of 12 150 children aged six years from 50 municipal kindergartens in Tianjin were enrolled in a cross-sectional survey. Their body weight, height and blood pressure were measured. Body length and weight at birth and one year of age were retrospectively collected. Rapid catch-up growth was defined as the difference of weight-for-height Z-score between one year old and at birth >0.67. The relationship between rapid growth with overweight and blood pressure in SGA and AGA infants at preschool age were analyzed using t test, analysis of variance and Chi-square test.@*Results@#At the age of six, children with rapid growth had a higher rate of overweight [28.6% (2 095/7 328) vs 17.5% (842/4 822), t=196.457, P<0.001], and higher systolic blood pressure [(99.4±10.0) vs (98.4±10.1) mmHg (1 mmHg=0.133 kPa), t=29.260, P<0.001] and diastolic blood pressure [(60.0±7.7) vs (59.4±7.8) mmHg, t=16.079, P<0.001] compared with children without rapid growth. SGA children with rapid growth had higher body weight [(21.5±4.4) vs (19.2±3.7) kg, t=3.747, P<0.001], height [(117.4±5.5) vs (114.8±5.4) cm, t=3.557, P<0.001] and systolic blood pressure [(98.4±9.9) vs (95.6±11.2) mmHg, t=2.080, P=0.038] compared with those without. Comparing to AGA children, SGA children had lower overweight rate [17.5% (144/824) vs 24.7% (2 793/11 326), t=21.630, P<0.001] and systolic blood pressure [(98.2±10.0) vs (99.0±10.1) mmHg, t=2.431, P=0.015]. Among the AGA children with rapid growth, 29.8% (1 958/6 564) were overweight.@*Conclusions@#Rapid growth in infancy is associated with overweight and higher systolic blood pressure at preschool age. A proper weight gain should be emphasized for both SGA and AGA infants.
ABSTRACT
Objective To explore the curative effects of mesenchymal stem cells(MSC)that overexpress in murine type 1 diabetes nephropathy (DN).Methods Mice were randomly divided into normal control(NC) group,DN group,C3-treated group,C3-MIGR1-treated group and C3-MIGR1-ICAM-1-treated group.Mice were given streptozotocin until the DN model was set up.The murine DN model was treated with murine MSC(C3H10T1/2),transfection empty vector of murine MSCs(C3H10T1/2-MIGR1/MSC) and murine MSCs (C3H10T1/2-ICAM-1/MSC)that overexpressed ICAM-1.After transplantation, the pathological features of kidneys were observed by Masson staining and the number of homing MSC cells to the kidney was calculated on days 1,3,7 by frozen section, while qPCR was used to analyze the expression of signaling molecules for collagen1, TGF-β1 and SMAD2 after treatment with various MSCs.Results Compared with DN group, the renal fibrosis treated with MSCs overexpressing ICAM-1 was significantly decreased by Masson staining.Three and seven days after transplant, the homing cells of MSC in different groups displayed no difference using tissue freezing section method.Furthermore, TGF-β1/SMAD signaling was lowly activated after the treatment with MSCs that overexpressed ICAM-1 compared with model mice(P<0.01).Conclusion MSCs that overexpress ICAM-1 can protect kidneys in the DN model.
ABSTRACT
Objective To investigate the characteristics of plasma glucose, insulin secretion and changes of insulin resistance (IR) after a glucose load in obese children, and to predict islet β-cell function. Methods A total of 635 obese children were classified into normal glucose tolerance (NGT) group (n=483), impaired glucose regulation (IGR) group (n=112) and type 2 diabetes mellitus (DM) group (n=40) based on their glucose levels. Subjects were also divided into G1 group (23 kg/m2≤BMI<30 kg/m2, n=393) and G2 group (BMI≥30 kg/m2, n=242) based on their different BMI levels. Level of fast plasma glucose (FPG, 0.5 h-PG, 1 h-PG, 2 h-PG and 3 h-PG) and insulin (FINS, 0.5 h-INS, 1 h-INS, 2 h-INS and 3 h-INS) were measured 0 h, 0.5 h, 1 h, 2 h and 3 h after a glucose load. Insulin resistance index (HOMA-IR), whole body insulin sensitivity index (WBISI), function of pancreatic beta-cell (HOMA-β), first-phase insulin secretion index (ΔI30/ΔG30) and area under curve of insulin (AUCI) were calculated and compared between groups. Results The value of insulin at each time point was significantly higher in IGR group than that of NGT group. The values of insulin at 0.5 h, 1 h, and 2 h were significantly lower in DM group than those of IGR group, respectively (all P<0.05). Compared with NGT group, AUCI, HOMA-IR and HOMA-β increased, but WBISI and ΔI30/ΔG30 decreased in IGR group (all P<0.05). HOMA-IR increased but WBISI, HOMA-βandΔI30/ΔG30 decreased in DM group (all P<0.05). Compared with IGR group, AUCI, HOMA-βandΔI30/ΔG30 decreased in DM group (all P<0.05). Values of FINS, AUCI, HOMA-IR, 2h-PG and HOMA-βwere significantly higher in G2 group than those of G1 group, but WBISI decreased (all P<0.05). There were no significant differences in FPG and ΔI30/ΔG30 between these two groups. Conclusion From NGT, IGR to DM, the peak of insulin secretion is postponed, insulin resistance is getting heavier and the compensation of insulin secretion after a glucose load is increased first and then decreased.
ABSTRACT
Objective To investigate the possible association of circulating components of GH-IGFs-IGFBPs system with the GHR-exon 3 genotype in idiopathic short stature (ISS) children. Methods Genomic DNA was extracted and isolat-ed from peripheral leukocytes in 108 ISS children. GHR-exon 3 polymorphism was analyzed with multiplex poly-merase chain reactions (PCR) assay. According to the results of genotype, ISS children were divided into GHRfl group and GHRd 3 group. The height and weight were recorded in two groups. The body mass index (BMI) and BMI standard deviation score (SDS) were measured. The serum levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, IGF-1 SDS and IGFBP3 SDS were calculated. GH stimulation test was used to measure the serum GH peak value. Fifty-five ISS chil-dren were treated with recombine human GH [0.15 IU/(kg·d)] for three months to analyse the association of IGF-1 response of GH treatment and genotypes. Results There were 63 GHRfl and 45 GHRd3 in 108 ISS children. There were no signifi-cant differences in BMI, IGF-1, IGFBP3, GH peak, IGF-1 SDS and IGFBP3 SDS between two groups (P>0.05). Multiple stepwise regression analysis showed that age, IGFBP3, lg (BMI) and lg (GH peak) were influencing factors of lgIGF-1 (P<0.05). In 55 ISS children treated with rhGH, there were 34 cases of GHRd3. The differences of △IGF-1 and △IGF-1 SDS were higher in GHRd3 group than those of GHRfl group (n=21). Conclusion The GH sensitivity may be a risk factor in ISS children, which may not be related with GHR polymorphism.
ABSTRACT
Objective To observe the effects of Lipopolysaccharide (LPS) in different concentrations on expression of Robo4 in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were cultured in vitro and randomly divided into 3 groups: control group, low dose LPS group (10 μg/mL) and high dose LPS group (100 μg/mL). Robo4 protein level was detected by immunofluorescence staining and western blot , and Robo4 mRNA level was measured by real-time PCR. Results Robo4 protein and Robo4 mRNA in high dose LPS group were 0.49 ± 0.08 and 0.23 ± 0.08 respectively , which were significantly decreased than those (1.35 ± 0.15 and 0.97 ± 0.17) in control group(P 0.05). Conclusion High dose LPS (100 μg/mL) could down-regulate expression of Robo4 in HUVECs.
ABSTRACT
Objective To investigate the association of eosinophils with glucose and lipid metabolism disorder in obese children. Methods A total of 180 subjects,102 boys and 78 girls,aged 7 to 14 years were enrolled in General Hospital,Tianjin Medical University. The subjects were divided into 3 quartiles according to eosinophil percentage. E1 (0 to<37% of eosinophils),E2(37% to<73% of eosinophils),and E3(73% to 100% of eosinophils). Forty-six chil-dren were selected as control group with matched age and sex (26 boys and 20 girls). The body weight,height,waist circumference,blood pressure,blood routine examination,fasting plasma glucose (FPG),fasting insulin (FINS),and blood lipid in 4 groups were measured. The values of glucose and lipid metabolism and the indexes of physical examina-tion were compared among each group. Results The values of eosinophil percentage,body mass index (BMI),trig-ly-ceride,total cholesterol, low-density lipoprotein cholesterol, FINS, FPG,homeostasis model assessment of insulin resistance(HOMA-IR) and waist circumference in E1,E2,E3 group were significantly higher than those in control group,and the value of high-density lipoprotein cholesterol was significantly lower than that in control group,and there were significant differences (all P<0. 05). The blood pressure was significantly higher in E1 groups than that in other 3 groups (all P<0. 05). The values of BMI and HOMA-IR in E1 group were higher than those of E3 group(all P<0. 05). Eosinophil percentage was positively correlated with FINS (r=0. 190,P=0. 01),and negatively correlated with BMI and HOMA-IR(r=-0. 259,-0. 190 respectively,all P<0. 05). Conclusions Obese children have emerged glucose and lipid metabolism disorders. Peripheral eosinophil percentage may be an early marker of insulin resistance.
ABSTRACT
Objective To study clinical value and significance of thyroid receptor stimulating antibody (TSAb) and thyroid stimulating-blocking antibody (TSBAb) on diagnosis and treatment for children with Graves’disease (GD) and Hashimoto’s thyroiditis (HT). Methods Eighty-eight children with autoimmune thyroid disease (AITD) and treatment time less six months were divided into GD group (n=55) and HT group (n=33). Thirty-eight healthy children were used as control (Normal group). Human serum TSAb ELISA kit and human TSBAb ELISA kit were used to detect the serum TSAb and serum TSBAb in three groups. The serum levels of TSAb and TSBAb were compared between three groups. The correla? tion between TSAb and TSBAb, TSAb/TSBAb and free triiodothyronine three (FT3), free thyroxine (FT4), ultra sensitive thy?roid stimulating hormone (TSH) were analyzed. Results The serum level of TSAb was significantly higher in GD group than that of HT group and Normal group (P0.05). There were no significant correlation between serum TSAb, TSBAb and FT3, FT4, TSH (P>0.05). Conclusion TSAb and TSBAb are related to the pathogenesis of GD and HT in children. TSAb and TSBAb have an important clinical value in the diagnosis and treatment for children with GD and HT.
ABSTRACT
OBJECTIVE To investigate the curative effect and mechanism of allo-bone marrow mes-enchymal stem cell(BM-MSC)infusion in the experimental autoimmune thyroiditis(EAT)mouse model. METHODS An EAT mouse model was established in C57BL/ 6 mice using porcine thyroglobulin(PTg) and Freund adjuvant,while BM-MSCs were injected into the EAT mice of BM-MSC treated group,3×105 per mouse on the 0,7th,14th and 21st day. On the 28th day,all the mice were sacrificed,and thyroid tissue was isolated,embedded in paraffin and stained with HE staining for histological examination. Serum was collected to assess the level of thyroglobulin antibodies( TgAb ) ,thyroid microsomal autoantibodies( TmAb),antithyroid peroxidase antibodies( TPOAb),3,5,3 ',5 '-tetraiodothyronine (TT4),3,5,3 '-triiodothyronine( TT3),interleukin-10( lL-10) and interferon-γ( lFN-γ ). RESULTS① Thyroid tissue in model group showed inflammatory response and infiltration. The level of TmAb, TgAb and TPOAb was significantly increased compared with normal control group,but the level of TT4 was decreased while there was no change in the level of TT3,suggesting that an EAT mouse model was established. ② The thyroid in model group and BM-MSC treated group showed inflammatory response and inflammatory cell infiltration,but the response in BM-MSC treated group was weaker than in model group. ③ Compared with model group,the level of TgAb,TmAb,TPOAb and lFN-γ was decreased obvi-ously(P﹤0.05),the level of TT4 and lL-10 was increased significantly(P﹤0.05),but the level of TT3 changed little in BM-MSC treated group. CONCLUSION BM-MSCs may partly restore the immunologi-cal homeostasis state. The mechanism may be related to its modulation of immune balance of Th1/ Th2.
ABSTRACT
Objective To study the relationship between the level of serum epithelial fatty acid binding protein (E-FABP) and cardiovascular disease in obese children. Methods Thirty children with metabolic syndrome (MS), 32 obesity children with no MS and 50 healthy children were recruited. Serum E-FABP and glucose/lipid metabolic indices were measured. Results Com-pared with the healthy children, levels of serum E-FABP in MS children were signiifcantly elevated (P=0.001). Compared with obesity children, levels of serum E-FABP of MS children were elevated, but the difference was not signiifcant (P>0.05). The cor-relations of E-FABP with waist to hip ratio, waist-to-height ratio, atherogenic index, fasting insulin, insulin resistance index were positive (P<0.05). According to the multivariate stepwise regression analysis, E-FABP was the independent risk of atherogenic index (P=0.018). Conclusions E-FABP plays a role in the development of atherosclerosis in obesity and MS.
ABSTRACT
The most common clinical manifestations of Hashimoto’s thyroiditis (HT) are goiter and hypothyroidism. The biochemical thyroid function varies quite widely among patients. Anti-TPO antibodies (TPOAbs) are the most sensitive index to screen HT. The thyroid function deteriorates gradually, and the hypothyroidism is the permanent sequeala of HT. The natural history of HT in children and adolescents is not fully known, and monitoring of thyroid function for all patients should be long-term. Children with hypothyroidism should be treated with levothyroxine replacement therapy.