The Thyroid Center at Boston Children’s Hospital remains the country’s most prolific research group for studies that increase the understanding of pediatric thyroid function and disease. In particular, our investigators are leading the charge in the study of childhood thyroid nodules and cancer. For example, our research suggests that adult systems for thyroid nodule evaluation, which have long been applied directly to children, require modifications to work optimally in a pediatric population. These and other findings are changing the way clinicians care for patients with pediatric thyroid disease.
Some of our key research findings include:
Thyroid nodules and cancer
- In children with thyroid nodules, autoimmune thyroiditis is associated with an increased risk of thyroid cancer.
- Describing when thyroid nodules or cancer develop in children with familial adenomatosis polyposis (FAP).
- Body weight is not associated with the risk of cancer in children with thyroid nodules.
- Underlying genetic tumor syndromes may be more common in patients with thyroid cancer than previously thought.
- Certain features of thyroid cancer may help guide which children can be treated with more limited surgery to reduce surgical risk and need for thyroid medication.
- Describing when thyroid nodules develop and how they progress in children with PTEN syndrome.
- A widely used ultrasound system for assessing risk of cancer in adults with thyroid nodules (TI-RADS) may miss a significant percentage of thyroid cancers in children.
- Children have a higher risk of cancer pediatric thyroid nodules than adults, even if the nodules have identical findings on initial evaluation. This implies some potential differences in how the standard cytology system (developed in adults) is applied to children.
- Thyroid nodules in children that are benign by biopsy are very unlikely to be cancerous. However, a few of these nodules may still harbor slow-growing thyroid cancers, so they should be followed by ultrasound yearly to make sure they do not grow or change.
- The largest published study demonstrating which ultrasound characteristics increase the risk of thyroid cancer in children with thyroid nodules.
- Autonomous (overactive) thyroid nodules in children, like in adults, are usually benign.
- A team with experience performing thyroid ultrasounds and biopsies in children can successfully diagnose thyroid cancer while avoiding unnecessary thyroid surgery in children who do not need it.
- Thyroid biopsies can be done safely and without sedation in almost all children.
- An experienced pediatric thyroid surgery team can perform thyroid surgery with a low risk of complications similar to that of high-volume adult thyroid surgeons.
- Children with thyroid cancer can be prepared for radioactive iodine therapy by stopping their thyroid medication for a short 2-week period.
Hypothyroidism
- Commentary on the 2022 FDA advisory to monitor thyroid function in children who receive iodinated contrast for imaging studies.
- Mild hypothyroidism does not affect outcomes in children undergoing heart surgery, and delaying surgery is usually not necessary.
- The first report of hypothyroidism in infants exposed to a new form of iodinated contrast used in radiology studies.
- Liothyronine may improve thyroid function tests in certain patients with congenital hypothyroidism.
- Hypothyroidism caused by too much iodine may be more common in infants born with heart disease than previously thought.
- Generic and brand-name levothyroxine (thyroid hormone) may not be equivalent for children with severe congenital hypothyroidism.
- Central hypothyroidism can be the first sign of PROP1 deficiency in children.
- Diets of hospitalized preterm infants may not contain enough iodine.
- Discovery of a new form of hypothyroidism in children.
Hyperthyroidism
- Discovery that the common antibiotic minocycline can cause thyroiditis.
- Pediatric Graves' disease: decisions regarding therapy.
- Discovery of new genetic factors associated with early onset of Graves’ disease.
- TSH receptor antibodies last longer in children than in adults with Graves’ disease, and their level does not predict how patients respond to treatment.