Thyroid hormone levels in children with heart disease at Kenyatta National Hospital

Abstract

Thyroid function among children with heart disease was studied. The children were randomly selected and included 35 children (11 cyanotic and 24 acyanotic) with Congenital Heart Disease (C.H.D.) and 34 children with Rheumatic Heart Disease (R.H.D.). Their heights, weights and thyroid hormone levels were compared with those of 43 normal control children matched for age and sex. 74% of boys and 87% girls with C. H. D. had heights below control values. 68% of boys and 87% of girls had weights below control values. Children with cyanotic - C.H.D. had significantly reduced Triiodothyronine (T3) and Thyroxine (T4). Their Thyroid Stimulating Hormone (T.S.H.) was essentially normal. There was a positive correlation between heights of children with cyanotic-C.H.D. and their T3 and T4 level. No such correlation was demonstrated between T3 and T4 levels and the weights of these children. Children with acyanotic-C.H.D. had significantly reduced T4 levels while T3 and T.S.H. remained normal.

In children with R.R.D. 86% of the boys and 52% of girls had heights below control values. 73% of the boys and 52% of the girls had weights below control values. Their thyroid hormones were essentially normal. No positive correlation between their heights, weights and their thyroid hormone levels was observed. These results suggest that altered thyroid hormone levels may affect height more than weight. They also suggest that T4 may be the earliest of the thyroid hormones to be affected in the hormonal changes that may take place in children with congenital heart lesions. More studies where other confounding factors in growth retardation are controlled for to try and establish a causal relationship between growth retardation in children with C.H.D. and their thyroid hormone levels were recommended.