Multivariate Analysis on Factors Affecting Suppression of Thyroid-Stimulating Hormone in Treated Congenital Hypothyroidism

Ng, Sze May; Wong, Sze Choong; Isherwood, D. M.; Smith, Colin; Didi, Mohammed

doi:10.1159/000081628

Cited by 6 publications

(2 citation statements)

References 46 publications

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“…Thyroid ectopia has been the most common aetiology and dyshormonogenesis the least common aetiology in recent studies (7,9,10 This discrepancy may be due to differences in populations studied and different screening evaluations used. We have previously reported that aetiology of CH was an independent factor affecting suppression of TSH and there were distinct hormonal profiles in response to treatment according to aetiology of CH (11). Our present study shows that responsiveness to treatment with LT4 showed no difference between sexes in the different aetiological groups, as judged by age at suppression of plasma TSH.…”

Section: Discussionsupporting

confidence: 52%

Biochemical severity of thyroid ectopia in congenital hypothyroidism demonstrates sexual dimorphism

Wong²,

Isherwood³

et al. 2007

eur j endocrinol

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Background: A recent study suggested that sexual dimorphism affects initial thyroid function in congenital hypothyroidism (CH) but differs according to aetiology of CH. Aims: To determine if sexual dimorphism was associated with biochemical severity of CH and its aetiology in our large British population. Methods: We examined retrospectively the initial thyroid function tests of 140 infants diagnosed with CH from screening. All infants underwent Tc-pertechnetate radionuclide scans at diagnosis to establish the aetiology of CH prior to commencement of treatment. Patients were classified into athyreosis, ectopia and presumed dyshormonogenesis on the basis of thyroid scans. A comparison of males and females were made within the three aetiological groups for gestational age, birth weight, initial dose of levothyroxine (LT4), screening TSH, confirmatory plasma thyroxine (T4), confirmatory plasma TSH and age of TSH suppression. Results: There was no significant difference between sexes for gestation, birth weight and initial treatment dose in all aetiological subgroups. In thyroid ectopia, screening TSH and confirmatory plasma TSH were significantly higher in females compared with males (P!0.01), while confirmatory plasma T4 were significantly lower in females (P!0.05). No difference was detected between males and females in athyreosis and dyshormonogenesis subgroups for screening TSH, confirmatory plasma TSH and total T4. Conclusion: Sexual dimorphism influenced the biochemical severity of thyroid ectopia in congenital hypothyroidism in our British population. However, this effect was not apparent in patients with athyreosis or dyshormonogenesis. Further advances in the molecular genetics of CH are essential to evaluate this phenomenon further.

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Section: Discussionsupporting

confidence: 52%

Biochemical severity of thyroid ectopia in congenital hypothyroidism demonstrates sexual dimorphism

Wong²,

Isherwood³

et al. 2007

eur j endocrinol

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“…Neonatal screening of CH has proved effective in preventing mental retardation and growth failure. L -Thyroxine supplementation must be started immediately since the psychometric final outcome strongly depends on the earliness of the hormonal therapy [4, 5]. Because CH may be permanent or transient, especially if the thyroid is normally located and in premature births, imaging often plays an important role in avoiding unnecessarily long T 4 therapy in patients with transient diseases or in optimizing thyroxine supplementation in permanent cases [6].…”

Section: Introductionmentioning

confidence: 99%

Scintigraphic Imaging of Paediatric Thyroid Dysfunction

et al. 2008

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Imaging of thyroid dysfunction is safe and clinically relevant in children. In congenital hypothyroidism (CH), thyroid imaging permits a precise characterization of the aetiology, which is important for genetic counselling and clinical management. CH may be due to thyroid dysgenesis (ectopia, hypoplasia and athyrosis) or occurs in eutopic glands. In the latter, hypothyroidism may be either transient, especially after iodine overload, or due to permanent autosomal recessive dyshormonogenesis. Thyroid scintigraphy (TS) with either ^99mTcO₄ or ¹²³I will identify ectopic thyroid tissue, which is the commonest cause of CH. However, recent reports favour the use of ¹²³I, which enhances the accuracy of the aetiological classification. In cases of eutopic thyroid, the measurement of ¹²³I uptake before and after perchlorate administration evaluates the organification process. At all ages, colour Doppler ultrasound scanning (CDU) is helpful in assessing thyroid volume, in identifying nodules and in characterizing tissue vascularization. TS and CDU images of most paediatric thyroid dysfunctions are presented.

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Ultrasound Measurements of Thyroid Gland Volume at 36 Weeks’ Corrected Gestational Age in Extremely Preterm Infants Born before 28 Weeks’ Gestation

Turner

Avula

2017

Eur Thyroid J

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Background: Thyroid ultrasound is a non-invasive imaging tool and provides good evaluation of thyroid anatomy, location, vascularisation, and echogenicity. The aim of this study was to assess thyroid function and thyroid volume in extremely preterm infants born before 28 weeks’ gestation evaluated at 36 weeks’ corrected gestational age (CGA) compared to term infants’ normative data in the literature. Design: In this largest prospective UK study of extremely premature infants born at less than 28 weeks’ gestation, thyroid volume measurement was assessed at 36 weeks’ CGA. Fifty-five extremely preterm infants (28 males) who were born before 28 weeks’ gestation were recruited to the study. All infants had ultrasound assessment of the thyroid gland at 36 weeks’ CGA. We also prospectively measured thyroid stimulating hormone (TSH) and free thyroxine (FT₄) in all infants at the time of recruitment (within 5 days of birth), at days 14, 21, and 28, and at 36 weeks’ CGA. Results: The mean thyroid volume was measured at 0.57 mL (SD ±0.18). There was no association between mean thyroid volume and thyroid function (TSH or FT₄). No associations were found between mean thyroid volume and gestation or birth weight in these infants. Conclusions: Our findings provide a reference range with a mean thyroid volume of 0.57 mL (SD ±0.18) in this extremely preterm age group if less than 28 weeks’ gestation. Thyroid volume at birth can vary from country to country due to variations in iodine intake as well as gestational age.

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Multivariate Analysis on Factors Affecting Suppression of Thyroid-Stimulating Hormone in Treated Congenital Hypothyroidism

Cited by 6 publications

References 46 publications

Biochemical severity of thyroid ectopia in congenital hypothyroidism demonstrates sexual dimorphism

Biochemical severity of thyroid ectopia in congenital hypothyroidism demonstrates sexual dimorphism

Scintigraphic Imaging of Paediatric Thyroid Dysfunction

Ultrasound Measurements of Thyroid Gland Volume at 36 Weeks’ Corrected Gestational Age in Extremely Preterm Infants Born before 28 Weeks’ Gestation

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