Can One Predict Resolution of Neonatal Hyperthyrotropinemia?

Aguiar, Luisa; Garb, Jane; Reiter, Edward O.; Visintainer, Paul; Singh, Rachana; Allen, Holley; Tonyushkina, Ksenia

doi:10.1016/j.jpeds.2016.04.011

Cited by 13 publications

(10 citation statements)

References 37 publications

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“…Gender is a known factor influencing neonatal TSH level. The percentage of neonatal HTT is higher among male newborns, in contrast with the higher number of female newborns with CH in general (6,16,39,40).…”

Section: How Does the Reported Frequency Of Htt Vary Depending On The Mode Of Identification And What Other Factors Does It Depend On?mentioning

confidence: 74%

Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review

Chiesa

Tellechea

2021

Front. Endocrinol.

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The purpose of this paper was to systematically summarize the published literature on neonatal isolated hyperthyrotropinemia (HTT), with a focus on prevalence, L-T4 management, re-evaluation of thyroid function during infancy or childhood, etiology including genetic variation, thyroid imaging tests, and developmental outcome. Electronic and manual searches were conducted for relevant publications, and a total of 46 articles were included in this systematic review. The overall prevalence of neonatal HTT was estimated at 0.06%. The occurrence of abnormal imaging tests was found to be higher in the persistent than in the transient condition. A continuous spectrum of thyroid impairment severity can occur because of genetic factors, environmental factors, or a combination of the two. Excessive or insufficient iodine levels were found in 46% and 16% of infants, respectively. Thirty-five different genetic variants have been found in three genes in 37 patients with neonatal HTT of different ethnic backgrounds extracted from studies with variable design. In general, genetic variants reported in the TSHR gene, the most auspicious candidate gene for HTT, may explain the phenotype of the patients. Many practitioners elect to treat infants with HTT to prevent any possible adverse developmental effects. Most patients with thyroid abnormalities and/or carrying monoallelic or biallelic genetic variants have received L-T4 treatment. For all those neonates on treatment with L-T4, it is essential to ensure follow-up until 2 or 3 years of age and to conduct medically supervised trial-off therapy when warranted. TSH levels were found to be elevated following cessation of therapy in 44% of children. Withdrawal of treatment was judged as unsuccessful, and medication was restarted, in 78% of cases. Finally, data extracted from nine studies showed that none of the 94 included patients proved to have a poor developmental outcome (0/94). Among subjects presenting with normal cognitive performance, 82% of cases have received L-T4 therapy. Until now, the precise neurodevelopmental risks posed by mild disease remain uncertain.

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Section: How Does the Reported Frequency Of Htt Vary Depending On The Mode Of Identification And What Other Factors Does It Depend On?mentioning

confidence: 74%

Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review

Chiesa

Tellechea

2021

Front. Endocrinol.

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“…Most of them evaluated the possible risk factors for primary CH. Reported risk factors for transient CH were as follows: iodine deficiency or excess, prematurity, old maternal age, male gender, retinopathy of prematurity, twin pregnancy, maternal autoimmune thyroid disease, intrauterine growth retardation, and cesarean delivery (19,24,26,33,51,56,63). Reported risk factors for permanent CH with dysgenesis of the thyroid gland were as follows: female gender, familial history of CH, birth in geographical areas with a high rate of the disease, old maternal age, ethnicity (Caucasians) but not seasonality (5,15,42,50,56,61).…”

Section: Resultsmentioning

confidence: 99%

“…By considering the reported group differences, we could design more studies for better understand- ing of different subgroups of CH. As mentioned previously, though there were studies regarding CH-related risk factors (6,34,36,44,47,49,56,59,63) there was no comprehensive review in this field. Moreover, for some important risk factors such as seasonality or gender differences, the results of studies were not in agreement.…”

Section: Discussionmentioning

confidence: 99%

“…Iodine deficiency or excess (18,26,34), gender (31,17), seasonality (5, 13, 20-22, 30, 67) maternal age (12,37,44,61,63), type of delivery (28,62) and maternal anti-thyroid drug use (6,27) were the risk factors with controversial reports. Though their role as CH-related risk factors has been demonstrated in previous studies, the findings are not conclusive.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review on the Risk Factors of Congenital Hypothyroidism

Hashemipour¹,

Samei²,

Kelishadi³

et al. 2019

J. Pediatr. Rev.

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Context: Congenital Hypothyroidism (CH) is the most common endocrine disorder and causes of preventable mental retardation in children. Objective: We aimed to review the reported CH-related risk factors systematically. Data Sources: In this review, all types of human studies on the risk factors related to the occurrence or high rate of CH were included. An electronic search was conducted in international and national electronic databases. The following keywords were used: "Congenital Hypothyroidism" AND "risk factor".

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“…Aguiar ve ark. 'nın (13) geçici konjenital hipotiroidinin erkeklerde 5 kat daha fazla olduğunu bildirdikleri çalışmalarında geçici konjenital hipotiroidi grubunda kalıcı gruba göre anne yaşı, sezaryen sıklığı ve prematüre retinopati sıklığının daha yüksek olduğu ve TSH yüksekliğinin maternal ve perinatal risk faktörleri ile ilişkili olabileceği rapor edilmiştir. Çalışmamızda, maternal ve perinatal risk faktörleri değerlendirilmediğinden bu konu ile ilgili yorum yapılamamıştır.…”

Section: Discussionunclassified

Etiological Evaluation of Congenital Hypothyroidism Cases

Anık¹,

Berber²,

Ünüvar³

et al. 2020

BUCH

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INTRODUCTION: The aim of this study was to determine, (i) the cause of congenital hypothyroidism (permanent or transient), (ii) the etiological cause of persistent congenital hypothyroidism and (iii) to investigate the role of clinical and laboratory data in predicting persistent and transient congenital hypothyroidism. METHODS: Patients with congenital hypothyroidism who were started L-thyroxine treatment and discontinued at the age of 3 years were included in the study. The data of the cases were obtained retrospectively from the hospital records. Serum thyroid hormones were measured of the cases 4 weeks after discontinuation of treatment at the age of 3 years. Patients with TSH> 10 mIU/mL were accepted as permanent hypothyroidism and those with normal TSH value for 6 months were accepted as transient hypothyroidism. RESULTS: A total of 63 patients were included in the study. Permanent congenital hypothyroidism was detected in 16 (25%: 9 females, and 7 males) and transient congenital hypothyroidism in 47 (75%: 22 females, and 25 males) cases. There was no difference between the permanent and transient groups in terms of gender, gestational week, birth weight, age at diagnosis, physical examination findings at the time of diagnosis, serum fT4, TSH levels, and initial L-thyroxine doses. While thyroid ultrasonography was normal in all patients in the transient hypothyroidism group, dysgenesis was detected in 9 (56%), and dyshormonogenesis in 1 (6%) patient. The mean thyroxin dose in permanent congenital hypothyroidism group was significantly higher than the transient group at the time of treatment cessation (2.8±0.9 and 1.2±0.5 mcg/kg/day, p<0.001, respectively). L-thyroxin dose of >2.1 mcg/kg/d was 81% sensitive and 90% specific for predicting permanent congenital hypothyroidism (p<0.001). DISCUSSION AND CONCLUSION: It has been shown that the most common etiologic cause of congenital hypothyroidism is transient hypothyroidism. Thyroxine dose at the time of treatment cessation was found to be the most important determinant in the differentiation of permanent and transient congenital hypothyroidism.

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Can One Predict Resolution of Neonatal Hyperthyrotropinemia?

Cited by 13 publications

References 37 publications

Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review

Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review

A Systematic Review on the Risk Factors of Congenital Hypothyroidism

Etiological Evaluation of Congenital Hypothyroidism Cases

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