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Etiology of Congenital Hypothyroidism

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Abstract

Congenital hypothyroidism (CH) is a condition of thyroid hormone deficiency present at birth. According to the duration of thyroid hormone deficiency, it may be classified into permanent and transient CH. According to the anatomic location of the pathogenic defect, CH may be further classified into primary, secondary (or central), and peripheral CH. The most frequent cause of permanent primary CH is thyroid dysgenesis, which includes thyroid ectopy, agenesis, and hypoplasia. Thyroid dysgenesis is generally sporadic in occurrence, but in about 2 % of cases, mutations in genes PAX8, TTF-2, NKX2.1, and NXK2.5 may be detected. Dyshormonogenesis is the second most common cause and may be caused by mutations in genes encoding the sodium-iodide symporter, thyroperoxidase, hydrogen peroxide generation factors, thyroglobulin, iodothyronine deiodinase, and pendrin. Rare causes of CH include resistance to TSH binding or signaling, central CH, and peripheral CH caused by thyroid hormone syndrome or defects in thyroid hormone transport and metabolism.

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References

  1. Olivieri A, Fazzini C, Medda E, Collaborators (2015) Multiple factors influencing the incidence of congenital hypothyroidism detected by neonatal screening. Horm Res Paediatr 83:86–93

    Article  CAS  PubMed  Google Scholar 

  2. Olivieri A, Radetti G, Medda E; The Italian Study Group for Congenital Hypothyroidism (2014) Incidence of congenital hypothyroidism in the Autonomous Province of Bolzano: benefit of increased iodine intake. J Endocrinol Invest [Epub ahead of print] PubMed

    Google Scholar 

  3. Park SM, Chatterjee VK (2005) Genetics of congenital hypothyroidism. J Med Genet 42:379–389

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Krude H, Biebermann H, Schnabel D, Ambrugger P, Grüters A (2000) Molecular pathogenesis of neonatal hypothyroidism. Horm Res 53:12–18

    Article  CAS  PubMed  Google Scholar 

  5. Grüters A, Biebermann H, Krude H (2003) Neonatal thyroid disorders. Horm Res 59:24–29

    Article  PubMed  Google Scholar 

  6. Castanet M, Polak M, Bonaiti-Pellie C et al (2001) Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. J Clin Endocrinol Metab 86:2009–2014

    Article  CAS  PubMed  Google Scholar 

  7. Bubuteishvili L, Garel C, Czernichow P, Leger J (2003) Thyroid abnormalities by ultrasonography in neonates with congenital hypothyroidism. J Pediatr 143:759–764

    Article  PubMed  Google Scholar 

  8. Al Taji E, Biebermann H, Límanová Z et al (2007) Screening for mutations in transcription factors in a Czech cohort of 170 patients with congenital and early-onset hypothyroidism: identification of a novel PAX8 mutation in dominantly inherited early-onset non-autoimmune hypothyroidism. Eur J Endocrinol 156:521–529

    Article  CAS  PubMed  Google Scholar 

  9. Clifton-Bligh RJ, Wentworth JM, Heinz P et al (1998) Mutation of the gene encoding human TTF-2 associated with thyroid agenesis, cleft palate and choanal atresia. Nat Genet 19:399–401

    Article  CAS  PubMed  Google Scholar 

  10. Krude H, Schutz B, Biebermann H et al (2002) Choreoathetosis, hypothyroidism, and pulmonary alterations due to human NKX-2.1 haploinsufficiency. J Clin Invest 109:475–480

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Ferrara AM, De Michele G, Salvatore E et al (2008) A novel NKX2.1 mutation in a family with hypothyroidism and benign hereditary chorea. Thyroid 18:1005–1009

    Article  CAS  PubMed  Google Scholar 

  12. Dentice M, Cordeddu V, Rosica A et al (2006) Missense mutation in the transcription factor NKX2-5: a novel molecular event in the pathogenesis of thyroid dysgenesis. J Clin Endocrinol Metab 91:1428–1433

    Article  CAS  PubMed  Google Scholar 

  13. Macchia PE, Lapi P, Krude H et al (1998) PAX8 mutations associated with congenital hypothyroidism caused by thyroid dysgenesis. Nat Genet 19:83–86

    Article  CAS  PubMed  Google Scholar 

  14. Vilain C, Rydlewski C, Duprez L et al (2001) Autosomal dominant transmission of congenital thyroid hypoplasia due to loss-of-function mutation of PAX8. J Clin Endocrinol Metab 86:234–238

    CAS  PubMed  Google Scholar 

  15. Kumar J, Gordillo R, Kaskel FJ, Druschel CM, Woroniecki RP (2009) Increased prevalence of renal and urinary tract anomalies in children with congenital hypothyroidism. J Pediatr 154:263–266

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Trueba SS, Auge J, Mattei G et al (2005) PAX8, TITF1, and FOXE1 gene expression patterns during human development: new insights into human thyroid development and thyroid dysgenesis-associated malformations. J Clin Endocrinol Metab 90:455–462

    Article  CAS  PubMed  Google Scholar 

  17. Grasberger H, Refetoff S (2011) Genetic causes of congenital hypothyroidism due to dyshormonogenesis. Curr Opin Pediatr 23:421–428

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Biebermann H, Schoneberg T, Krude H et al (1997) Mutations of the human thyrotropin receptor gene causing thyroid hypoplasia and persistent congenital hypothyroidism. J Clin Endocrinol Metab 82:3471–3480

    CAS  PubMed  Google Scholar 

  19. Grasberger H, Vaxillaire M, Pannain S et al (2005) Identification of a locus for nongoitrous congenital hypothyroidism on chromosome 15q25.3-26.1. Hum Genet 118:348–355

    Article  CAS  PubMed  Google Scholar 

  20. Grasberger H, Mimouni-Bloch A, Vantyghem MC et al (2005) Autosomal dominant resistance to thyrotropin as a distinct entity in five multigenerational kindreds: clinical characterization and exclusion of candidate loci. J Clin Endocrinol Metab 90:4025–4034

    Article  CAS  PubMed  Google Scholar 

  21. Persani L (2012) Clinical review: central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin Endocrinol Metab 97:3068–3078

    Article  CAS  PubMed  Google Scholar 

  22. Olateju TO, Vanderpump MP (2006) Thyroid hormone resistance. Ann Clin Biochem 43:431–440

    Article  CAS  PubMed  Google Scholar 

  23. Friesema EC, Jansen J, Heuer H et al (2006) Mechanisms of disease: psychomotor retardation and high T3 levels caused by mutations in monocarboxylate transporter 8. Nat Clin Pract Endocrinol Metab 2:512–523

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Gianni Bona .

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Bona, G., Bellone, S., Prodam, F., Monzani, A. (2015). Etiology of Congenital Hypothyroidism. In: Bona, G., De Luca, F., Monzani, A. (eds) Thyroid Diseases in Childhood. Springer, Cham. https://doi.org/10.1007/978-3-319-19213-0_3

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  • DOI: https://doi.org/10.1007/978-3-319-19213-0_3

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19212-3

  • Online ISBN: 978-3-319-19213-0

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