{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T10:43:22Z","timestamp":1777805002194,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Valproate is known to have various adverse effects including hormonal dysfunction. There is debate in literature regarding the association between valproate therapy and subclinical hypothyroidism, with some studies suggesting a potential link. However, none of the studies on our review have noted overt hypothyroid symptoms with subclinical hypothyroidism. We present a pediatric patient with generalized epilepsy on long-term valproate therapy who developed subclinical hypothyroidism with overt hypothyroid symptoms. Our patient initially presented as a 3-year-old with absence epilepsy and was well-controlled with valproate monotherapy. After more than 2 years of seizure freedom, the patient developed symptoms of hypothyroidism, leading to a diagnosis of grade 2 subclinical hypothyroidism. Symptom resolution occurred with discontinuation of valproate and with initiation of levothyroxine. Ultimately, thyroid studies normalized, and levothyroxine was also discontinued. Although subclinical hypothyroidism is a known potential side effect of valproate therapy, this case demonstrates that overt hypothyroid symptoms are rare, but possible.<\/jats:p>","DOI":"10.1177\/08830738251366864","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T06:33:44Z","timestamp":1755671624000},"page":"416-418","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Subclinical Hypothyroidism With Overt Symptoms in Patient With Well-Controlled Epilepsy on Valproate Therapy: A Case Report"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6693-8216","authenticated-orcid":false,"given":"Samarth","family":"Doshi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Northwestern University's Feinberg School of Medicine and The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3942-5466","authenticated-orcid":false,"given":"Kelly A","family":"Denhard","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6423-1065","authenticated-orcid":false,"given":"Kathryn LI","family":"Xixis","sequence":"additional","affiliation":[{"name":"University of Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2013.06.012"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1611144"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2007.07.003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1999.tb01595.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073811421985"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.02.046"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1313913"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-08-0325"},{"key":"e_1_3_2_10_2","volume-title":"The Harriet Lane Handbook: A Manual for Pediatric House Officers","author":"Anderson CC","year":"2024","unstructured":"Anderson CC, Kapoor S, Mark TE. 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