Thyroid volumes in newborns of different gestational ages: normative data

Kurtoğlu, Selim; Öztürk, Merve; Köklü, Esad; Güneş, Tamer; Akçakuş, Mustafa; Yıkılmaz, Ali; Büyükkayhan, Derya; Hatipoğlu, Nihal

doi:10.1136/adc.2007.130211

Cited by 10 publications

(11 citation statements)

References 3 publications

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“…Total thyroid volume was the sum of the volumes of two lobes (24). Thyroid gland was considered goitrous when its total volume exceeded +2 standard deviation (SD) score of the volume found by Kurtoglu et al (25) for Turkish newborns of different gestational ages. Thyroid scintigraphy (scan) with 99mTc-pertechnetate was performed using a Siemens Orbiter gamma camera equipped with a pinhole collimator (Siemens, Erlangen, Germany).…”

Section: Methodsmentioning

confidence: 99%

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

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Objective: Prevalence of congenital hypothyroidism (CH) in Turkey at birth was reported to be as high as 1:650 in 2008-2010. Incidence rates of permanent and transient CH separately are unknown due to lack of follow-up data. We aimed to evaluate the impact of transient hypothyroidism on increasing incidence of CH and to determine the natural course and the clinical, biochemical, and imaging characteristics of transient CH.Methods: Baseline and follow-up data of the infants with CH detected at screening in six provinces in the Black Sea Region were analyzed retrospectively during a time period covering the years 2008-2010.Results: Among 138 cases (48% female), 16 (12%) showed transient hyperthyrotropinemia which resolved without intervention. Of the treated 122 cases, 63 (52%) had transient CH. While its frequency was 35% in 2008, it increased to 56% in 2009-2010, following a lowering of the thyroid stimulating hormone cutoff value. The frequency was higher in inland provinces than in coast (67% vs. 43%; p=0.01).Clinical characteristics of permanent and transient cases were similar except female-to-male sex ratios (1.5:1 vs. 0.6:1; p=0.02). L-thyroxine was discontinued in 70% of transient cases before 3 years of age at a median age of 19 (2-36) months. The only indication for early discontinuation of treatment was a low L-thyroxine dose, which was 1.25±0.27 µg/kg/day at withdrawal time.Conclusion: Our regional follow-up data showed that more than half of newborns with primary CH had transient thyroid dysfunction. In the majority of cases, discrimination between transient and permanent CH can be made before age 3 years, as indicated by cessation of L-thyroxine treatment.

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Section: Methodsmentioning

confidence: 99%

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

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“…This discrepancy might be partly accounted for by the relatively high reference range established for Scottish data. Certainly, thyroid size was greater in Perry’s study than in comparable studies from countries such as Turkey, 23 Poland, 24 China, 25 Germany 26 and Belgium 27 ( Table 4 ). Smoking has been shown to have a goitrogenic effect in adults, with increased thyroid size in the newborn of mothers who were smokers 28 and neither smoking nor iodine status were evaluated in Perry’s study.…”

Section: Discussionmentioning

confidence: 79%

Determination of thyroid volume in infants with suspected congenital hypothyroidism—the limitations of both subjective and objective evaluation

Mansour¹,

Ouarezki²,

Jones

et al. 2020

BJR|Open

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Objective: To compare two methods of assessing gland size on thyroid ultrasound in newborn infants with suspected congenital hypothyroidism (CH). Methods: Images from infants with eutopic glands referred between 2007 and 2013 were evaluated blind by two sets of observers. Subjective gland size was categorised as small, borderline-small, normal, borderline-large and large. Objective gland volume, calculated as the sum of each lobe using the prolate ellipsoid formula (length x width x depth x π/6), was put into corresponding categories: <0.8, 0.81–1.0, 1.1– <2.2, 2.2–2.4 and >2.4 ml, derived from normative Scottish data. Results: Of 36 infants, permanent CH was present in 17, transient CH in 17, status uncertain in 2. Mean (SD) intraobserver error for thyroid volume measurement was 0.11 (0.23) ml [8.3%]. Subjective assessment by two observers was discordant in only four (10.8%) infants. However, subjective vs objective evaluation was discordant in 14 (39%). Eight (three permanent, five transient CH) had large glands subjectively but normal glands objectively; and six (four transient CH) had normal glands subjectively but small glands objectively. The former infants all showed a single flattened curve to the anterior thyroid margin, giving an impression of bulkiness. Gland shape was normal in the latter infants. Conclusion: Neither subjective nor objective evaluation predicts permanent vs transient CH. Altered gland shape may confound both methods, and undermine use of the conventional formula for measuring lobe volume. Advances in knowledge: Until more refined methods are available for assessing thyroid size, both subjective and objective evaluation are recommended in CH.

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“…Dexamethasone, along with methimazole and levothyroxine, was associated with a loss in volume of .50% in the thyroid lobes in a 4-week period, although the lobes remained more than 3 times larger than the average volume expected for a full-term neonate. 9 There is no standard treatment, beyond establishment of the euthyroid state, to decrease the size of neonatal goiter more rapidly. Because GD-related antibodies can remain in the neonatal circulation for up to 12 weeks, 10 the concern was that the thyroid gland was continuing to be stimulated.…”

Section: Discussionmentioning

confidence: 99%

Thyroid “Vise” in an Infant With Neonatal Graves’ Disease

Regelmann

Sullivan²,

Rapaport

2013

Pediatrics

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On the rare occasion when neonatal goiter is the cause of airway compromise, it typically presents with a palpable neck mass. In the setting of maternal Graves' disease (GD), fetal and neonatal goiters are most commonly caused by maternal treatment with antithyroid medication, and the goiter resolves within days of initiation of thyroxine replacement in the neonate. We describe an atypical presentation of a patient with severe neonatal GD born to a euthyroid mother at 35 weeks' gestational age with respiratory compromise, symptoms of hyperthyroidism, and a nonpalpable thyroid gland. The mother had a history of GD treated with radioactive iodine ablation; during the pregnancy she was treated with levothyroxine throughout and propylthiouracil beginning at 5 months' gestation, for fetal tachycardia. Laboratory testing after birth confirmed neonatal GD. The patient was treated with methimazole, Lugol' s solution, and levothyroxine, and the patient remained euthyroid from day of life 10. After multiple extubation attempts failed, the patient was found on visualization studies to have a large, predominantly posterior, "vise-like" goiter encasing the larynx and upper trachea. The patient was successfully extubated, and all medications were discontinued on day of life 60. The patient remained euthyroid 1 month after discontinuation of treatment. The patient' s atypical presentation illustrates the need for early neck imaging in patients with neonatal GD and respiratory distress, especially when the thyroid gland is not palpable. Treatment options for resolving a goiter due to neonatal GD are not clear.

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Thyroid volumes in newborns of different gestational ages: normative data

Cited by 10 publications

References 3 publications

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Determination of thyroid volume in infants with suspected congenital hypothyroidism—the limitations of both subjective and objective evaluation

Thyroid “Vise” in an Infant With Neonatal Graves’ Disease

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