Adult Height in Congenital Hypothyroidism: Prognostic Factors and the Importance of Compliance with Treatment

Bain, Philippa; Toublanc, Jean-Edmond

doi:10.1159/000064489

Cited by 41 publications

(28 citation statements)

References 18 publications

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“…Even if the CH infants today may have an even better intellectual and neurological prognosis, a subtle impairment of the neurological development and a loss in some IQ points are still detectable [5,18,19,20,21,22,23], whereas the growth is normal in all of them [9,24,25,26,27]. …”

Section: Discussionmentioning

confidence: 99%

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

et al. 2007

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Aims: To evaluate therapy and dose adjustments in patients with congenital hypothyroidism (CH), longitudinally followed up until 16 years old, according to aetiology, Beclard’s nuclei presence, and thyroxine (T4) level at diagnosis. Methods:L-T4/kg/day and dose change ratio (CR) were assessed in 74 CH patients. Results: The dose was statistically larger in athyreosis than in dyshormonogenesis (1–10 and beyond 14 years) and in ectopy (2, 15, 16 years). The ectopic children required statistically larger L-T4/kg than the dyshormonogenetic ones (3–7 years). The L-T4/kg/day was increased, not statistically, in patients or with T4 <30 nmol/l or without Beclard’s nuclei at diagnosis. The CR progressively dropped after the 6th month at each attendance, without any difference in terms of aetiology, T4 level at diagnosis, or Beclard’s nuclei. The total CR was greater (significantly) in patients without Beclard’s nuclei, and (not significantly) in those with T4 <30 nmol/l at diagnosis or with agenesia. Conclusion: The L-T4 dose in CH is highly affected by the aetiology. The CR is higher in patients with delayed bone maturation at diagnosis. We suggest that these latter patients need blood tests more frequently to obtain a proper titration of the therapy.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

et al. 2007

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“…Moreover, an initial higher dose in the patients of Salerno et al [11]is related to an earlier date of normalization of TSH. In our experience, early normalization of TSH is related to further good compliance [7], which is per se another prognostic factor for good outcome [10, 19]. …”

Section: Discussionmentioning

confidence: 99%

“…Before 1984, it was the total thyroxine (tT4) levels that were measured; these values were therefore converted into fT4 using the formula: fT4 = (2.207 × tT4) – 3.09 (r 2 = 0.925; r = 0.96; p < 0.001) [7]. The ESK was determined on an anteroposterior X ray of the knee and measured in square millimetres.…”

Section: Methodsmentioning

confidence: 99%

Earlier Onset of Treatment or Increment in LT4 Dose in Screened Congenital Hypothyroidism: Which Was the More Important Factor for IQ at 7 Years?

et al. 2004

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Objective: To determine between timing and LT4 dose which was the more important factor for IQ at 7 years in screened congenital hypothyroidism (CH). Methods: 131 children with CH born from 1979 to 1994 and 30 controls were studied. Mean age at recall: 22.8 ± 1.1 days. Mean initial LT4: 5.6 ± 0.1 µg/kg/day. Results: Optimal global IQ (GIQ; 119.0 ± 1.8) was obtained for a recall ≤15 days. Results for a recall after 3 weeks were lower (107.7 ± 2.4). The IQ of infants treated before 21 days (117.1 ± 1.2) was identical to the IQ of controls (117.0 ± 2.3) whereas the IQ of those treated after this threshold was lower (108.6 ± 1.7). No significant differences for GIQ were observed with various initial LT4 doses. Infants treated with a dose of LT4 ≧6 µg/kg/day had a higher performance IQ (117.3 ± 1.8 vs. 112.8 ± 1.2) compared with those treated with a dose <6 µg/kg/day. The severity of CH and socio-economic levels were similar in all groups. Conclusion: In this study, timing appears to be the more important factor for the intellectual outcome.

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“…With respect to the achievement of a normal final height, some studies have suggested that the adequacy of L-thyroxine replacement in the first 6 months of life may influence the adult height of children with CH detected by newborn screening [12]. In contrast, other studies have found no correlation between severity at diagnosis, etiology, or initial L-thyroxine dosage [13, 14]. The only postnatal factor consistently found to be related to adult height has been the age at the start of treatment.…”

Section: Discussionmentioning

confidence: 99%

Effect of Prolonged Discontinuation of L-Thyroxine Replacement in a Child with Congenital Hypothyroidism

Kubicky

Weiner

Carlson

et al. 2012

Case Reports in Endocrinology

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When diagnosed through neonatal screening and treated promptly and adequately, infants with congenital hypothyroidism (CH) experience normal physical growth and neurological development. Here we present a 3-year-old boy diagnosed with CH as a newborn, who was subsequently left untreated and experienced significant growth failure and developmental delay. This case emphasizes the importance of a consistent adherence to treatment in preventing such complications, especially in infancy and early childhood.

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Adult Height in Congenital Hypothyroidism: Prognostic Factors and the Importance of Compliance with Treatment

Cited by 41 publications

References 18 publications

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

Earlier Onset of Treatment or Increment in LT4 Dose in Screened Congenital Hypothyroidism: Which Was the More Important Factor for IQ at 7 Years?

Effect of Prolonged Discontinuation of L-Thyroxine Replacement in a Child with Congenital Hypothyroidism

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