Early treated hypothyroidism: development at 3 years.

Murphy, Glynis H.; Hulse, J A; Jackson, Doreen; Tyrer, P; Glossop, John R; Smith, I.; Grant, D B

doi:10.1136/adc.61.8.761

Cited by 29 publications

(21 citation statements)

References 19 publications

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“…Murphy et al (17) showed that children who had a low T4 and triiodothyronine did significantly less well on the McCarthy general cognitive index at 3 yr, and noticed that children with very delayed bone age also did relatively poorly (1 7). This was suggested long ago by Wolter et al (1 8) and more recently confirmed by Rovet et al (19).…”

Section: Discussionmentioning

confidence: 99%

Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

et al. 1988

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ABSTRACT. The Quebec Network for Genetic Medicine has followed the development of some 100 hypothyroid children treated by 1 month of age and evaluated at 18 months, 3 and 5 yr and the Griffiths Mental Development Scales, then at 7 and 9 yr with the Wechsler Intelligence Scale for Children Revised. Results show that the children as a group reach scores within the normal range of the tests. However, a few patients have low scores at each evaluation. Previously, we showed a correlation between a low serum thyroxine concentration, or a relatively retarded bone maturation before treatment, and low mental scores. To better characterize the significance of this relationship we correlated these pretreatment factors and the Wechsler Intelligence Scale for Children Revised results of 43 subjects reaching the age of 7 yr. Again, the same correlation was observed. Calculating a predictive factor (low thyroxine, <2 pg/dl and retarded bone surface, ~0 . 0 5 cm2) from data recorded before therapy initiation, 10 of 13 children were correctly predicted to have I.Q. values <90. The use of these parameters might permit early intervention, and allow specific guidance of the more affected subjects. (Pediatr Res 24: [6][7][8] 1988)

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Section: Discussionmentioning

confidence: 99%

Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

et al. 1988

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“…On one-tailed ^tests, cases were doing significantly less well than their matched controls on the full McCarthy GCI and quantitative scale only (p < 0.05). The only other significant difference between cases and controls at 3 years was a slight slowing on the speeded motor skills task in the cases, as has already been reported (Murphy et al, 1986).…”

Section: (B) Results At 3 Yearsmentioning

confidence: 54%

“…At 3 years children with very low initial T4 (< 20 nmol/1) and/or low initial T3 ( < 2.0 nmol/1) had significantly lower IQs (short-form McCarthy GCIs) than those with higher initial T4 and T3 (Murphy et al, 1986). Indeed, initial T4 and T3 correlated significantly with a number of measures of psychological outcome, including the full McCarthy GCI, several of the McCarthy subscales and the speed on the pegboard task (see Table 2).…”

Section: (B) Results At 3 Yearsmentioning

confidence: 96%

Congenital Hypothyroidism: Physiological and Psychological Factors in Early Development

Murphy¹,

Hulse²,

Smith³

et al. 1990

Child Psychology Psychiatry

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Children diagnosed as congenitally hypothyroid and treated from a very early age were followed up at 1 and 3 years. At 1 year they seemed to be developing normally, unless they were undertreated or had an additional disorder. There were no significant correlations between biochemical or social factors and psychological outcome at 1 year. At 3 years, however, those children whose T4 and/or T3 had been very low initially had significantly lower IQ scores than both other hypothyroid children and matched controls. Children with only moderately low initial T4 and/or T3, however, were doing just as well as their matched controls. Initial levels of TSH, the number of symptoms at first clinical interview and the age at the start of treatment were not good indicators of ability at 3 years. Undertreatment was rare but did appear to affect ability. Psychological outcome at 3 years was also correlated with social class (for both cases and controls). Multiple regression analyses indicated that both low initial T4 (less than 20 nmol/l) and social class contributed significantly to outcome.

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“…In CHT, treatment started after the age of 6 wk leads to more intellectual and neurologic deficits than treatment started before 6 wk of age (1, 2). But even in the group of early treated infants, defects are observed in fine motor coordination, concentration, speech, hearing, and learning (2)(3)(4). This may be the consequence of prenatal thyroid hormone deficiency, despite substantial transplacental transport of T4 to a CHT fetus (5).…”

Section: T3 Triiodothyroninementioning

confidence: 99%

Somatosensory Evoked Potentials in Neonates with Primary Congenital Hypothyroidism during the First Week of Therapy

et al. 1991

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ABSTRACT. At the present, the influence of intrauterine hypothyroidism on the fetus is estimated by bone age (BA). BA is also used as a predictor of later neuropsychologic development. The aim of this study was to investigate whether the neurophysiologic maturation of neonates with congenital hypothyroidism (CHT) is delayed at the start of therapy and, if so, whether this delay is comparable to that in BA. Twenty-seven infants with CHT were examined with median nerve somatosensory evoked potentials (SEP) before or within 1 wk after initiation of therapy. The effect of neonatal jaundice, a potential confounder of neonatal SEP, was also evaluated. Cervical (N13), first cephalic (N19), and second cephalic (N32) peak latencies were measured, as well as N13-N19 interval (central conduction time) and N13 latency divided by arm length. The SEP data of 103 normal infants were used as reference values. In the CHT newborns, a maturational delay was found for all SEP parameters. Preterm infants (n = 3) were conspicuously less affected than term patients. In term CHT infants, jaundice during the first postnatal week, but not late jaundice, had an additional adverse effect. SEP delay was not related to initial or actual T4 levels. BA delay exceeded SEP delay by several weeks. Our data suggest that the depressed T4 levels of the hypothyroid fetus and neonate affect the nervous tissue to a lesser degree than bone tissue and, further, that SEP is superior to BA as parameter for the evaluation of neurologic maturation of infants with CHT. (Pediatr Res 30: 34-39, 1991)

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Early treated hypothyroidism: development at 3 years.

Cited by 29 publications

References 19 publications

Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

Congenital Hypothyroidism: Physiological and Psychological Factors in Early Development

Somatosensory Evoked Potentials in Neonates with Primary Congenital Hypothyroidism during the First Week of Therapy

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