Advertisement

Indian Pediatrics

, Volume 55, Issue 12, pp 1059–1061 | Cite as

Prediction of Transient or Permanent Congenital Hypothyroidism from Initial Thyroid Stimulating Hormone Levels

  • Maria Scavone
  • Elena Carboni
  • Ettore Stefanelli
  • Giusy Romano
  • Anna Vero
  • Laura Giancotti
  • Roberto Miniero
  • Valentina TalaricoEmail author
Research Paper
  • 9 Downloads

Abstract

Objective

To identify factors that discriminate between transient and permanent congenital hypothyroidism.

Methods

Retrospective evaluation of 58 children with congenital hypothyroidism and eutopic thyroid gland. Gender, gestational age, birth weight, TSH and serum thyroxine levels at diagnosis and L-thyroxine dose at 12 and 24 months of age were analyzed.

Results

Median (IQR) initial TSH levels were 73.3 (276.5) μIU/mL in permanent hypothyroidism and 24.24 (52.7) μU/mL in transient hypothyroidism (P =0.0132). The optimum cut-off value of initial TSH to predict transient hypothyroidism was 90 μIU/mL. Mean (SD) L-thyroxine doses at 24 months of age were 2.64 (0.98) μg/kg/day in permanent hypothyroidism and 1.91 (0.65) μg/kg/day in transient hypothyroidism. Requirement of Lthyroxine dose at 24 months of ≤0.94 μg/kg/day had the highest sensitivity (100%) to predict transient hypothyroidism.

Conclusions

L-thyroxine doses at 24 months can predict transient hypothyroidism in patients with eutopic thyroid gland earlier than at 36 months.

Keywords

Cretinism Transient hypothyroidism Thyroid hormones Thyroxine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010;5:17.CrossRefGoogle Scholar
  2. 2.
    Cassio A, Corbetta C, Antonozzi I, Calaciura F, Caruso U, Cesaretti G, et al. The Italian screening program for primary congenital hypothyroidism: Actions to improve screening, diagnosis, follow–up, and surveillance. J Endocrinol Invest. 2013;36:195–203.Google Scholar
  3. 3.
    Leger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, et al. European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism. J Clin Endocrinol Metab 2014;99:363–84.CrossRefGoogle Scholar
  4. 4.
    Cho MS, Cho GS, Park SH, Jung MH, Suh BK, Koh DG. Earlier re–evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L–thyroxine doses. Ann Pediatr Endocrinol Metab. 2014; 19:141–5.CrossRefGoogle Scholar
  5. 5.
    Rabbiosi S, Vigone MC, Cortinovis F, Zamproni I, Fugazzola L, Persani L, et al. Congenital hypothyroidism with eutopic thyroid gland: Analysis of clinical and biochemical features at diagnosis and after re–evaluation. J Clin Endocrinol Metab. 2013;98:1395–402.CrossRefGoogle Scholar
  6. 6.
    Hong SY, Chung HR, Lee SY, Shin CH, Yang SW. Factors distinguishing between transient and permanent hypothyroidism in patients diagnosed as congenital hypothyroidism by newborn screening. J Korean Soc Pediatr Endocrinol. 2005;10:154–60.Google Scholar
  7. 7.
    Kang MJ, Chung HR, Oh YJ, Shim YS, Yang S, Hwang IT. Three–year follow–up of children with abnormal newborn screening results for congenital hypothyroidism. Pediatr Neonatol. 2017;58:442–8.CrossRefGoogle Scholar
  8. 8.
    Unuvar T, Demir K, Abacý A, Atas A, Buyukgebiz A, Bober E. Monitoring and prognostic evaluation of patients with congenital hypothyroidism treated in a pediatric endocrinology unit. Turk J Pediatr. 2013;55:384–90.Google Scholar
  9. 9.
    Messina MF, Aversa T, Salzano G, Zirilli G, Sferlazzas C, De Luca F, et al. Early discrimination between transient and permanent congenital hypothyroidism in children with eutopic gland. Horm Res Paediatr. 2015;84:159–64.CrossRefGoogle Scholar
  10. 10.
    Srinivasan R, Harigopal S, Turner S, Cheetham T. Permanent and transient congenital hypothyroidism in preterm infants. Acta Paediatr. 2012;101:e179–82.CrossRefGoogle Scholar
  11. 11.
    Chung HR, Shin CH, Yang SW, Choi CW, Kim BI, Kim EK, et al. High incidence of thyroid dysfunction in preterm infants. J Korean Med Sci. 2009;24:627–31.CrossRefGoogle Scholar
  12. 12.
    Lim G, Lee YK, Han HS. Early discontinuation of thyroxine therapy is possible in most very low birthweight infants with hypothyroidism detected by screening. Acta Paediatr. 2014;103:e123–9.CrossRefGoogle Scholar
  13. 13.
    Olivieri A, Fazzini C, Medda E, Italian Study Group for Congenital Hypothyroidism.Multiple factors influencing the incidence of congenital hypothyroidism detected by neonatal screening. Horm Res Paediatr. 2015;83:86–93.CrossRefGoogle Scholar
  14. 14.
    Zdraveska N, Anastasovska V, Kocova M. Frequency of thyroid status monitoring in the first year of life and predictors for more frequent monitoring in infants with congenital hypothyroidism. J Pediatr Endocrinol Metab. 2016;29: 795–800.CrossRefGoogle Scholar

Copyright information

© Indian Academy of Pediatrics 2018

Authors and Affiliations

  • Maria Scavone
    • 1
  • Elena Carboni
    • 1
  • Ettore Stefanelli
    • 1
  • Giusy Romano
    • 1
  • Anna Vero
    • 2
  • Laura Giancotti
    • 1
  • Roberto Miniero
    • 1
  • Valentina Talarico
    • 3
    • 4
    Email author
  1. 1.Unit of PediatricsMagna Graecia University of CatanzaroCatanzaroItaly
  2. 2.Units of Laboratory MedicineCatanzaroItaly
  3. 3.Pediatrics, Pugliese- Ciaccio HospitalCatanzaroItaly
  4. 4.Unit of PediatricsPugliese-Ciaccio HospitalViale Pio XItaly

Personalised recommendations