Clinical Monitoring Guidelines for Congenital Hypothyroidism: Laboratory Outcome Data in the First Year of Life

Balhara, Bharti; Misra, Madhusmita; Levitsky, Lynne L.

doi:10.1016/j.jpeds.2010.10.006

Cited by 27 publications

(17 citation statements)

References 25 publications

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“…The frequent monitoring of TSH and FT4 levels is required for this and also for preventing the occurrence of prolonged periods of supraphysiological thyroid hormone levels [94,95,96]. After adjustment to L-T 4 dosage, it is appropriate to recheck thyroid function, and the recommended interval of 4-6 weeks is in keeping with the American Academy of Pediatrics guidelines [8].…”

Section: 2 Monitoring Of Treatment and Adverse Eventsmentioning

confidence: 99%

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Léger¹,

et al. 2014

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Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T₄ supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy.

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Section: 2 Monitoring Of Treatment and Adverse Eventsmentioning

confidence: 99%

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Léger¹,

et al. 2014

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“…A child with a confirmed diagnosis of CH needs prompt treatment with L-thyroxine and the etiological research may be delayed until 3 years of age, considering that the first concern is to preserve the child's developing central nervous system, growth and cognitive capacity (12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism

Borges

Sedassari

et al. 2017

Arch. Endocrinol. Metab.

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Objectives: To describe the findings of thyroid ultrasonography (T-US), its contribution to diagnose congenital hypothyroidism (CH) and the best time to perform it. Subjects and methods: Forty-four patients with CH were invited to undergo T-US and 41 accepted. Age ranged from 2 months to 45 years; 23 patients were females. All were treated with L-thyroxine; 16 had previously undergone scintigraphy and 30 had previous T-US, which were compared to current ones. Results: At the current T-US, the thyroid gland was not visualized in its normal topography in 10 patients (24.5%); 31 T-US showed topic thyroid, 17 with normal or increased volume due to probable dyshormonogenesis, 13 cases of hypoplasia and one case of left-lobe hemiagenesis. One patient had decreased volume due to central hypothyroidism. Scintigraphy scans performed 3-4 years earlier showed 100% agreement with current results. Comparisons with previous T-US showed concordant results regarding thyroid location, but a decrease in current volume was observed in eight due to the use of L-thyroxine, calling the diagnosis of hypoplasia into question. Conclusions: The role of T-US goes beyond complementing scintigraphy results. It allows inferring the etiology of CH, but it must be performed in the first months of life. An accurate diagnosis of CH will be attained with molecular study and the T-US can guide this early assessment, without therapy withdrawal. Arch Endocrinol Metab. 2017;61(5):432-7

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“…Our practice harmonize the recent recommendation: follow-up Normal values: T 4 : 9,0-15,0 (newborn: -20,0) μg/dl; T 3 : 1,5-3,5 (newborn: -4,0) ng/ml; TSH: 0,5-5,0 (newborn: -20,0) mIU/L Table 5. Correlation between starting L-T 4 dose and changes of thyroid parameters during hormone replacement Congenital Hypothyroidism http://dx.doi.org/10.5772/54660 every 1-2 months in the first 6 months, every 2-3 months between 6 months and 3 yrs of age and every 6-12 months later in childhood [52,53].…”

Section: Or T 4 + T 3 Replacementmentioning

confidence: 99%

Congenital Hypothyroidism

Péter¹,

Muzsnai²,

Gráf³

2013

Current Topics in Hypothyroidism With Focus on Development

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Clinical Monitoring Guidelines for Congenital Hypothyroidism: Laboratory Outcome Data in the First Year of Life

Cited by 27 publications

References 25 publications

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism

Congenital Hypothyroidism

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