Congenital Hypothyroidism: Long-Term Experience with Early and High Levothyroxine Dosage

Uyttendaele, Marie; Lambert, Sophie; Tenoutasse, Sylvie; Boros, Emese; Ziereisen, F.; Vliet, Guy Van; Heinrichs, Claudine; Brachet, Cécile

doi:10.1159/000443958

Cited by 12 publications

(15 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CH is a systemic metabolic disorder due to insufficient production of thyroid hormones due to thyroid gland malformation or disturbance in hormonal biosynthesis. It is a hereditary disease that, if left untreated, seriously compromises intellectual growth and development, since it is considered one of the few causes of intellectual disability that can be prevented when diagnosed and treated early 5,8 . PKU refers to the autosomal recessive metabolic disorder.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of parents regarding newborn screening test, after accessing the website “Babies’ Portal” - Heel prick test

et al. 2017

View full text Add to dashboard Cite

Purpose: to assess the knowledge of mothers about the heel prick test, develop contents on this test to make it available on the "Babies' Portal" website, evaluate and validate the informative material developed. Methods: this study was conducted in three stages, that is, the first stage which is about a descriptive study involving 105 mothers of newborn children before performing the neonatal screening "Heel Prick Test", the second one consisting in the development of the website "Babies' Portal", and the third stage, the evaluation and validation of this material carried out by 20 parents of children between zero and 36 months old, who underwent the neonatal screening Heel Prick Test by accessing the website "Babies' Portal". Results: although the interviewed mothers knew that their children had the right to be tested, they showed no knowledge of the diseases that can be prevented, time of diagnosis, nor the consequences arising from the lack of early diagnosis and treatment. The website creation and validation gathered basic information about the Heel Prick Test, and the participants regarded the content from satisfactory to excellent. Conclusion: it is necessary that families know not only about the procedures their children will undergo, but also the reason they are performed and the consequences of failing in doing so.

show abstract

Section: Introductionmentioning

confidence: 99%

Knowledge of parents regarding newborn screening test, after accessing the website “Babies’ Portal” - Heel prick test

et al. 2017

View full text Add to dashboard Cite

show abstract

“…This was attributed to the fact that the majority of patients were from rural areas and probably have some difficulties in accessing their results of screening as well as in admission to our tertiary pediatric endocrine centre. While in some studies, a female predominance has been reported, some others, showed a male predominance ( 8 , 9 , 10 , 11 , 12 , 13 , 14 ). In the present study, there was a slight female predominance.…”

Section: Discussionmentioning

confidence: 92%

“…Patients with eutopic thyroid gland account for (54%) of cases with permanent CH ( Figure 1 ). When considering the aetiology of permanent CH, in previous studies, thyroid dysgenesis was reported to cause 75-85% of permanent CH cases which was followed by dyshormonogenesis cases with eutopic glands ( 5 , 13 ). However, a considerable shift has been observed in the incidence rate as well as the ratio of transient and permanent cases with a change in the cut-off values which had been used for neonatal screening programs ( 5 , 8 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

Validity of Six Month L-Thyroxine Dose for Differentiation of Transient or Permanent Congenital Hypothyroidism

Asena¹,

Demiral²,

Ünal³

et al. 2020

Jcrpe

View full text Add to dashboard Cite

Objective: The tendency to reduce thyroid stimulating hormone (TSH) referral cut-off values in congenital hypothyroidism (CH) neonatal screening programs has resulted in an increase in the incidence of CH, but also the referral of infants with mild transient elevation of TSH. Therefore, there is a need to develop markers for differentiation of transient elevated TSH and permanent CH as early as safely possible to avoid unnecessary treatment. The aim was to evaluate sixth-month L-thyroxine (LT4) dose as a predictive marker for differentiation of transient elevated TSH and permanent CH. Methods: Data of patients who had been followed after referral from the neonatal screening programme between the year 2010 and 2019 in a tertiary pediatric endocrine centre were examined retrospectively. Results: There were 226 cases referred, of whom 186 (82.3%) had eutopic thyroid gland, and 40 (17.7%) had dysgenetic gland. In patients with a dysgentic gland there was a non-significant tendency to have lower diagnostic free thyroxine concentration but significantly higher TSH compared with those with eutopic gland (p=0.44 and p=0.023, respectively). Patients with thyroid dysgenesis required higher initial and six month LT4 doses compared with those with eutopic glands (p=0.001). Receiver operator curve analysis showed the optimum cut-off value for LT4 at six months for transient vs. permanent CH was 2 μg/kg/day (sensitivity 77% and specificity 55%), regardless of etiology. Similarly, in patients with eutopic glands the optimum cut-off value for LT4 dose at six months for permanent vs. transient patients was 2 μg/kg/day (sensitivity 72% and specificity 54%). Conclusion: Results suggest that LT4 requirement at six months of therapy may be a good marker for predicting transient TSH elevation in patients with eutopic thyroid gland, thus facilitating the decision to halt LT4 therapy.

show abstract

“…Early and continuous treatment with LT4 has been shown to promote normal growth [8,9] and BMD or other indices of bone health [10][11][12] in children with congenital hypothyroidism, relative to their euthyroid peers ( Fig. 1), and normal BMD in adults [13].…”

Section: Patients With Congenital Hypothyroidismmentioning

confidence: 99%

Levothyroxine and Bone

Wang

2021

70 Years of Levothyroxine

View full text Add to dashboard Cite

Thyroid hormones play an important role in the development of the skeleton in children, and in maintaining bone mineral content in adults. Hyperthyroidism is associated with loss of bone mineral content, with increased risk of fractures. This has raised concerns that treatment (especially over treatment) with levothyroxine (LT4) might mimic these adverse effects on the skeleton. Clinical data on the effects of LT4 administration on bone are conflicting. In general, the use of LT4 to maintain euthyroid levels of thyroid hormones in patients with hypothyroidism, or even the use of thyrotropin-suppressive therapy following removal of thyroid tumours, does not appear to carry a substantial risk of osteoporosis or fractures. Nevertheless, a cautious approach to avoid over treatment is recommended, especially in patients with or at risk of developing osteoporosis.

show abstract

Congenital Hypothyroidism: Long-Term Experience with Early and High Levothyroxine Dosage

Cited by 12 publications

References 37 publications

Knowledge of parents regarding newborn screening test, after accessing the website “Babies’ Portal” - Heel prick test

Knowledge of parents regarding newborn screening test, after accessing the website “Babies’ Portal” - Heel prick test

Validity of Six Month L-Thyroxine Dose for Differentiation of Transient or Permanent Congenital Hypothyroidism

Levothyroxine and Bone

Contact Info

Product

Resources

About