Factors Associated with Permanent Hypothyroidism in Infants with Congenital Hypothyroidism

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2019 Nov 23

PMID 31752783

Citations 14

Authors

Eun Sil Park

Ju Young Yoon

Affiliations

Soon will be listed here.

Abstract

Background: Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation.

Methods: We gathered data regarding infants diagnosed with CH between July 2005 and July 2015 by retrospective chart review. Those with aplastic, hypoplastic or ectopic glands on thyroid ultrasonography or scan were excluded. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age.

Results: From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 μg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH (3.8 vs 2.5 μg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 μg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine.

Conclusion: The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH.

Citing Articles

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High frequency of transient congenital hypothyroidism among infants referred for suspected congenital hypothyroidism from the Turkish National screening program: thyroxine dose may guide the prediction of transients.

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The prevalence of hypothyroxinemia in premature newborns.

Stawerska R, Nowak-Bednarek M, Talar T, Kolasa-Kicinska M, Lupinska A, Hilczer M Front Endocrinol (Lausanne). 2022; 13:940152.

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