{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:08Z","timestamp":1791821048608,"version":"4.3.4"},"reference-count":11,"publisher":"Walter de Gruyter GmbH","issue":"11","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2022-0345_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Iodine deficiency goiter can develop in children on a restrictive diet and most have normal thyroid function. We report a 6-year-old girl with iodine deficiency goiter with thyroid function studies mimicking thyroid hormone resistance alpha. Thyroid hormones mediate its effects through thyroid hormone receptors alpha and beta. Biochemical picture of low\/low-normal T4 and high\/high-normal T3 levels, variably reduced reverse T3 and normal TSH is characteristic of thyroid hormone resistance alpha.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0345_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>A 6-year-old girl, born out of non-consanguineous marriage presented with goiter of 1.5\u00a0years duration. She was without symptoms of thyroid dysfunction. The patient was evaluated at one\u00a0year of age for macrocephaly with cranial ultrasound which was normal. She had normal growth and development. Patient was vegan and was not on any medications or supplements. Laboratory work up showed TSH 5.03\u00a0uIU\/mL (0.34\u20135.5), FT4 0.3\u00a0ng\/dL (0.58\u20131.2), FT3 5.3\u00a0pg\/mL (2.5\u20133.9), total T3 258\u00a0ng\/dL (94\u2013241), reverse T3 &lt;5.0\u00a0ng\/dL (8.3\u201322.9) and negative thyroglobulin antibody and thyroid peroxidase antibody. Thyroglobulin level was 1,098.8\u00a0ng\/mL (&lt;13\u00a0ug\/L), and urine iodine 15.8 ug\/L (&lt;100\u00a0ug\/L) confirming a diagnosis of iodine deficiency goiter. Patient was started on iodine supplements, 150 ug daily and repeat work up 3\u00a0months later were TSH: 2.717\u00a0uIU\/mL, T3, total 182\u00a0ng\/dL, T4, total 9.3\u00a0ug\/dL, FT 4 2.1\u00a0ng\/dL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0345_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Iodine deficiency goiter may present with low FT 4, elevated T3 and normal TSH mimicking thyroid hormone resistance alpha and should be considered in children on restrictive diet.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2022-0345","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T01:47:53Z","timestamp":1663120073000},"page":"1433-1436","source":"Crossref","is-referenced-by-count":6,"title":["Thyroid function tests of iodine deficiency goiter can mimic thyroid hormone resistance alpha"],"prefix":"10.1515","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0391-3759","authenticated-orcid":false,"given":"Sabitha","family":"Sasidharan Pillai","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology , Hasbro Children\u2019s Hospital , Providence , USA"},{"name":"Department of Pediatrics , The Warren Alpert Medical School of Brown University , Providence , Rhode Island , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Bernardo","family":"Quintos","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology , Hasbro Children\u2019s Hospital , Providence , USA"},{"name":"Department of Pediatrics , The Warren Alpert Medical School of Brown University , Providence , Rhode Island , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"2023040100342191812_j_jpem-2022-0345_ref_001","doi-asserted-by":"crossref","unstructured":"Brooks, MJ, Post, EM. Acquired hypothyroidism due to iodine deficiency in an American child. J Pediatr Endocrinol Metab 2014;27:1233\u20135. https:\/\/doi.org\/10.1515\/jpem-2014-0226.","DOI":"10.1515\/jpem-2014-0226"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_002","doi-asserted-by":"crossref","unstructured":"Yeliosof, O, Silverman, LA. Veganism as a cause of iodine deficient hypothyroidism. J Pediatr Endocrinol Metab 2018;31:91\u20134. https:\/\/doi.org\/10.1515\/jpem-2017-0082.","DOI":"10.1515\/jpem-2017-0082"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_003","doi-asserted-by":"crossref","unstructured":"Leniszewski, S, Mauseth, R. Goiter and multiple food allergies. Int J Pediatr Endocrinol 2009;2009:628034. https:\/\/doi.org\/10.1186\/1687-9856-2009-628034.","DOI":"10.1186\/1687-9856-2009-628034"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_004","doi-asserted-by":"crossref","unstructured":"Booms, S, Hill, E, Kulhanek, L, Vredeveld, J, Gregg, B. Iodine deficiency and hypothyroidism from voluntary diet restrictions in the US: case reports. Pediatrics 2016;137:e20154003. https:\/\/doi.org\/10.1542\/peds.2015-4003.","DOI":"10.1542\/peds.2015-4003"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_005","doi-asserted-by":"crossref","unstructured":"Ikomi, C, Cole, CR, Vale, E, Golekoh, M, Khoury, JC, Jones, NY. Hypothyroidism and iodine deficiency in children on chronic parenteral nutrition. Pediatrics 2018;141:e20173046. https:\/\/doi.org\/10.1542\/peds.2017-3046.","DOI":"10.1542\/peds.2017-3046"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_006","doi-asserted-by":"crossref","unstructured":"Zimmermann, MB, Boelaert, K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol 2015;3:286\u201395. https:\/\/doi.org\/10.1016\/s2213-8587(14)70225-6.","DOI":"10.1016\/S2213-8587(14)70225-6"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_007","doi-asserted-by":"crossref","unstructured":"Moran, C, Chatterjee, K. Resistance to thyroid hormone due to defective thyroid receptor alpha. Best Pract Res Clin Endocrinol Metabol 2015;29:647\u201357. https:\/\/doi.org\/10.1016\/j.beem.2015.07.007.","DOI":"10.1016\/j.beem.2015.07.007"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_008","doi-asserted-by":"crossref","unstructured":"de Vijlder, JJ. Primary congenital hypothyroidism: defects in iodine pathways. Eur J Endocrinol 2003;149:247\u201356. https:\/\/doi.org\/10.1530\/eje.0.1490247.","DOI":"10.1530\/eje.0.1490247"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_009","doi-asserted-by":"crossref","unstructured":"Erba\u015f, \u0130M, Demir, K. The clinical spectrum of resistance to thyroid hormone alpha in children and adults. J Clin Res Pediatr Endocrinol 2021;13:1\u201314. https:\/\/doi.org\/10.4274\/jcrpe.galenos.2020.2019.0190.","DOI":"10.4274\/jcrpe.galenos.2020.2019.0190"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_010","doi-asserted-by":"crossref","unstructured":"Obregon, MJ, Escobar del Rey, F, Morreale de Escobar, G. The effects of iodine deficiency on thyroid hormone deiodination. Thyroid 2005;15:917\u201329. https:\/\/doi.org\/10.1089\/thy.2005.15.917.","DOI":"10.1089\/thy.2005.15.917"},{"key":"2023040100342191812_j_jpem-2022-0345_ref_011","doi-asserted-by":"crossref","unstructured":"Semiz, S, Senol, U, Bircan, O, G\u00fcm\u00fc\u015fl\u00fcS, KorgunDK, Ak\u00e7urinS, et al.. Thyroid hormone profile in children with goiter in an endemic goiter area. J Pediatr Endocrinol Metab 2001;14:171\u20136. https:\/\/doi.org\/10.1515\/jpem.2001.14.2.171.","DOI":"10.1515\/JPEM.2001.14.2.171"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0345\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0345\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T15:52:53Z","timestamp":1680364373000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0345\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,15]]},"references-count":11,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,9,21]]},"published-print":{"date-parts":[[2022,11,25]]}},"alternative-id":["10.1515\/jpem-2022-0345"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2022-0345","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,15]]}}}