Predictors of intellectual outcome in a cohort of brazilian children with congenital hypothyroidism

Kreisner, Edmundo; Schermann, Lígia Braun; Camargo-Neto, E.; Gross, Justine

doi:10.1046/j.1365-2265.2004.01974.x

Cited by 27 publications

(19 citation statements)

References 27 publications

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“…Sin embargo, el tratamiento con dosis altas de levotiroxina se asocia con episodios en que los niveles de T4 pueden aumentar en forma suprafisiológica, lo que puede provocar déficit en el estado de alerta y en el control inhibitorio 32 , alteraciones del temperamento 33 y problemas de atención, comportamiento y psiquiátricos durante la infancia 34 . Es por esta razón que un seguimiento exhaustivo y frecuente se hace imperativo, y ya ha sido demostrado que un mayor número de evaluaciones durante los primeros años de vida se correlaciona con mejores resultados de neurodesarrollo 20,31 .…”

Section: Rol De Las Hormonas Tiroideas En El Desarrollo Del Sistema Nunclassified

Alteraciones del neurodesarrollo en pacientes con hipotiroidismo congénito: Recomendaciones para el seguimiento

et al. 2017

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Congenital hypothyroidism (CH) is the most common cause of preventable cognitive disability worldwide. Generally, it is produced by an alteration in the embryogenesis of the thyroid gland or by an alteration in the synthesis of thyroid hormones, which determine that affected patients have low or absent thyroid hormone concentrations. The importance of this fact is that brain development during the first three years of life is highly dependent on thyroid hormones. Prior to the implementation of national neonatal screening programs around the world, 8 to 27% of children with CH had an IQ lower than 70. Nowadays, this percentage is close to 0 in countries that have implemented the program. In Chile, CH neonatal screening program achieved national coverage in 1996. Currently, the incidence of the disease in our country is 1: 3163. The degree of disability produced by CH not only depends on the time of detection of the disease and the prompt start of therapy, but also on an adequate monitoring. Despite screening programs, neurocognitive impairment in schoolchildren and teenagers with CH is still observed, reflected in lower scores in cognitive, language and gross motor assessments, receptive communication, expressive communication, fine motor and gross motor skills compared to healthy children. Also, lesser achievements in learning and language disorders are observed. The objective of this review is to update the information available on neurodevelopment of patients with CH.

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Section: Rol De Las Hormonas Tiroideas En El Desarrollo Del Sistema Nunclassified

Alteraciones del neurodesarrollo en pacientes con hipotiroidismo congénito: Recomendaciones para el seguimiento

et al. 2017

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“…Some reported that a high dose of L-T4 and rapid thyroid-stimulating hormone (TSH) normalization were associated with an improvement in the intelligence quotient (IQ) score compared with low-dose treatment, whereas others suggested that the timing of treatment was the most important factor3456). Maintaining a high level of T4 by administration of a high dose of L-T4 may increase the risk of craniosynostosis and neurological symptoms, and did not affect cognitive outcomes at 11 years of age7).…”

Section: Introductionmentioning

confidence: 99%

Intellectual development in preschool children with early treated congenital hypothyroidism

Seo

Yoon

et al. 2017

Ann Pediatr Endocrinol Metab

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PurposeDelayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH.MethodsWe retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence.ResultsThe patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76–126). None had intellectual disability (defined as an IQ <70). Twenty-one subjects were treated with a low dose (6.0–9.9 µg/kg/day) and 22 with a high dose of levothyroxine (10.0–16.0 µg/kg/day). There was no significant difference in the mean full-scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis.ConclusionIQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

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“…In 31 CH subjects studied at 4 years of age, a higher baseline T4 was one of the main predictors of increased verbal IQ but, interestingly, levothyroxine dose at the beginning of treatment and thyroid hormone levels during treatment did not relate to IQ outcome. 15 In relation to the initial starting dose of T4, Gauchard and colleagues 16 showed in 17 patients that early normalisation of TSH (before 3 months) was necessary to allow for normal neurosensorial afferent pathway development (vestibular, proprioceptive), as well as pathways of central integration (cerebellum, vestibular nuclei). The Norwegian study of 49 patients 17 showed that the initial T4 dose predicted verbal IQ at age 20, but the authors have expressed concern at some negative associations between high dose treatment and developmental outcome.…”

Section: Readmission Of Neonatesmentioning

confidence: 99%

The evolution of paediatric hospitals

Goldbloom¹

2005

Archives of Disease in Childhood

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Predictors of intellectual outcome in a cohort of brazilian children with congenital hypothyroidism

Abstract: Maternal schooling, number of visits during the first year of life and baseline T4 levels were the main predictors of cognitive outcome in this cohort of patients.

Cited by 27 publications

References 27 publications

Alteraciones del neurodesarrollo en pacientes con hipotiroidismo congénito: Recomendaciones para el seguimiento

Alteraciones del neurodesarrollo en pacientes con hipotiroidismo congénito: Recomendaciones para el seguimiento

Intellectual development in preschool children with early treated congenital hypothyroidism

The evolution of paediatric hospitals

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