Treatment and follow-up of children with transient congenital hypothyroidism

Yang, Rulai; Zhu, Zhiwei; Zhou, Xuelian; Zhao, Zhiyuan

doi:10.1631/jzus.2005.b1206

Cited by 13 publications

(18 citation statements)

References 9 publications

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“…It was thought that the similarity in sex distribution might be related with limited the number of subjects or a finding reflecting a characteristic of the Western regions of Turkey. In the literature, it has been reported that transient PCH occurs more commonly in the male sex (16,18,21). In our study, the number of male subjects was higher and the female/male ratio was 1:2.1 in the transient PCH group, similar to the literature.…”

Section: Discussionsupporting

confidence: 90%

Etiological evaluation of primary congenital hypothyroidism cases

et al. 2017

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Aim: Primary congenital hypothyroidism is frequently seen endocrine disorder and one of the preventable cause of mental retardation. Aim of study was to evaluate the frequency of permanent/transient hypothyrodism, and to detect underlying reason to identfy any marker which carries potential to discriminate permanent/transient form. Material and Methods:Forty eight cases older than 3 years of age, diagnosed as primary congenital hypothyroidism and started thyroxin therapy in newborn-period, and followed up between January 2007-June 2013 were included in the study. Thyroid hormon levels were evaluated and thyroid ultrasonography was performed in cases who are at the end of their 3 years of age, after 6 weeks of thyroxine free period. Thyroid sintigraphy was performed if serum thyroid-stimulating hormone was high (≥ 5 mIU/mL) and perchlorate discharge test was performed if uptake was normal or increased on sintigraphy. Cases with thyroid-stimulating hormone levels ≥ 5 mIU/mL were defined as permanent primary congenital hypothyroidism group and as transient primary congenital hypothyroidism group with normal thyroid hormones during 6 months. Results:The mean age was 3.8±0.7 years. Mean diagnosis age was 16.6±6.5 days and 14 cases (29.2%) were diagnosed by screening program of Ministry of Health. There were 23 cases (14F, 9M) in permanent primary congenital hypothyroidism group and 12 (52.2%) of them were dysgenesis (8 hypoplasia, 4 ectopia), and 11 (47.8%) dyshormonogenesis. In transient primary congenital hypothyroidism group, there were 25 cases (17M, 8F). The mean thyroid-stimulating hormone levels at diagnosis were similar in two groups. The mean thyroxin dose in permanent primary congenital hypothyroidism group was significantly higher than transient group at the time of thyroxin cessation (2.1±0.7, 1.5±0.5 mg/ kg/d, respectively, p=0.004). Thyroxin dose ≥1.6 mcg/kg/d was 72% sensitive and 69.6% specific for predicting permenant primary congenital hypothyroidism. Conclusions:Transient primary congenital hypothyroidism is more frequent than expected and found often in males in the primary congenital hypothyroidism cases, started thyroxin therapy in neonatal period. While fT4, thyroid-stimulating hormone, Tg levels at diagnosis do not predict transient/permenant primary congenital hypothyroidism, thyroxin dose before the therapy cessation at the age of 3 may make the distinction between transient/permenant primary congenital hypothyroidism. (Turk Pediatri Ars 2017; 52: 85-91)

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Section: Discussionsupporting

confidence: 90%

Etiological evaluation of primary congenital hypothyroidism cases

et al. 2017

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“…In our study, these parameters were similar in the groups. Yang et al (15) reported that physical and mental growth following treatment discontinuation in patients with transient hypothyroidism (when they were 2-3 years of age; at the 1-year follow-up) were similar to that of healthy children. Similarly, Demirel et al (16) found age-appropriate normal results in the Denver developmental screening test in patients with hyperthyrotropinemia.…”

Section: Discussionmentioning

confidence: 96%

The Role of Initial Clinical and Laboratory Findings in Infants With Hyperthyrotropinemia to Predict Transient or Permanent Hypothyroidism

Ünüvar¹,

Demir²,

Abacı³

et al. 2013

JCRPE

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Objective: Studies on the clinical course of children with hyperthyrotropinemia are scarce. We aimed to evaluate the role of presentation findings in such infants to predict eventual outcome.Methods: Files of infants diagnosed as suspicious congenital hypothyroidism (CH) in the neonatal or early infancy period in the past ten years were analyzed retrospectively, and 37 patients (M/F: 20/17) with hyperthyrotropinemia diagnosed at a median age of 3.2 months were included in the study. Criteria for inclusion were: normal free thyroxine (fT4) levels and thyrotropin (TSH) levels between 10-20 μIU/mL during the initial neonatal screening (or TSH<10μIU/mL afterwards). Cases with permanent CH (Group 1) were compared to those with transient hyperthyrotropinemia (Group 2) regarding age at the time of diagnosis, sex, gestational age, birth weight, symptoms, ultrasonographic and scintigraphic findings, initial thyroid function tests, and state of mental and motor development.Results: Of the total group, 20 patients (54%) were eventually diagnosed as permanent CH. T4 doses that maintained normal thyroid function tests were significantly higher at the end of the first and second years of life in this group. Age, TSH and fT4 levels at the time of diagnosis, sex, gestational age, birth weight, symptoms, ultrasonographic and scintigraphic findings, and the state of mental and motor development were similar in the two groups.Conclusions: T4 dose required to maintain a euthyroid state was the only parameter which distinguished between transient and permanent CH.Conflict of interest:None declared.

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“…In another study conducted by Dimitropoulos A, authors concluded that using 14.7 μg/kg/d at initiation of treatment led to significant higher IQ compared to the control group (111.4 versus 101.7; P < 0.0001) (19). Despite much data available in favor of using high doses, in one study it was mentioned that a dose of 3.21-5.81 µg/kg/d was adequate for the treatment of transient CH (20) and in another study elevated levels of FT4 were observed in many patients, showing that a systematic higher initial dosage could expose many children to the complications of hyperthyroidism (21). …”

Section: Resultsmentioning

confidence: 99%

Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review

Rahmani

Yarahmadi

Etemad

et al. 2016

Int J Endocrinol Metab

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ContextAppropriate management of neonates, tested positive for congenital hypothyroidism (CH), in particular, the initial dosage of levothyroxine and the time of initiation of treatment is a critical issue. The aim of this study was to assess all current evidence available on the subject to ascertain the optimal initial dose and optimal initiation time of treatment for children with CH.Evidence AcquisitionIn this study, all published research related to the initiation treatment dose and the onset time of treatment in congenital hypothyroidism were reviewed. The searched electronic databases included Medline, Science direct, Scopus EMBASE, PsycINFO, Cochrane, BIOSIS and ISI Web of Knowledge. Additional searches included websites of relevant organizations, reference lists of included studies, and issues of major thyroid and pediatrics journals published within the past 35 years. Studies were included if they were written in English and investigated levothyroxine dose or timing of treatment or both, used for the treatment of children with congenital hypothyroidism.ResultsTwo thousand three hundred and seventy-four articles (excluding duplicates) were retrieved from the primary search. After reviewing the titles, abstracts and full-texts of studies, eventually, 22 studies were found that met our inclusion criteria. Amongst these, 17 and 12 evaluated outcomes of different treatment doses and treatment timing, respectively. Overall, the majority of these studies emphasized the initial high dose of levothyroxine and early treatment of newborns with hypothyroidism. There were, however, some studies that disagreed with increasing levothyroxine dose at initiation of treatment.ConclusionsConsidering the results of this review, apparently there is no difference in opinion regarding the early initiation of treatment, whereas determining the optimal dose of levothyroxine for start of treatment in CH patients still remains a controversial issue, demonstrating the need for further studies, despite the fact that use of high doses can lead to rapid normalization of biochemical indices, although this may cause complications.

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Treatment and follow-up of children with transient congenital hypothyroidism

Cited by 13 publications

References 9 publications

Etiological evaluation of primary congenital hypothyroidism cases

Etiological evaluation of primary congenital hypothyroidism cases

The Role of Initial Clinical and Laboratory Findings in Infants With Hyperthyrotropinemia to Predict Transient or Permanent Hypothyroidism

Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review

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