Factors predicting final height in early treated congenital hypothyroid patients

Delvecchio, Maurizio; Salerno, Mariacarolina; Acquafredda, Angelo; Zecchino, C.; Fico, Francesca; Manca, Fabio; Faienza, Maria Felicia

doi:10.1111/j.1365-2265.2006.02651.x

Cited by 26 publications

(16 citation statements)

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“…In support of this view, in a large Italian cohort of children with CH followedup till the end of their growth, the final height was higher than target height in both sexes. [17] Salerno et al . [13] followed up children with CH diagnosed by screening and treated for > 16 years and reported that the group of children who received higher L-thyroxine dose (> 8 μg/kg/day) at the beginning of therapy attained a final height (0.4 ± 1.0 SDS), which was within the normal range for the reference population but significantly above their target height.…”

Section: Discussionmentioning

confidence: 99%

Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study

Soliman¹,

Azzam²,

Elawwa³

et al. 2012

Indian J Endocr Metab

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Introduction:Different growth and neuro-developmental outcomes have been associated with different doses of thyroxine given to infants with congenital hypothyroidism (CH).Materials and Methods:We studied the longitudinal growth pattern and assessed the neurodevelopment of 45 children with CH(25 girls, 20 boys) diagnosed through the national screening program in Qatar, for 6 years or more to examine the effects of initial T4 dosage (50 μg/day) with adjustment of T4 dose to maintain serum free T4 concentrations within the upper quartile of normal range and thyroid stimulating hormone < 4 mIU/mLThe birth size of newborns with CH diagnosed through the screening program before January 2003, was recorded and their growth in weight and stature was monitored every 3 months for at least 6 years of life. The IQ of children was assessed between 3 and 6 years of age using The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III).Results:Birth weight, length, and head circumference of patients (3.21 ± 0.43 kg, 50.5 ± 3.21 cm and 34.1 ± 1.5 cm, respectively) did not differ than those for 10,560 normal newborns with normal thyroid function (3.19 ± 0.59 kg, 50.5 ± 2.2 cm and 34.2 ± 1.7 cm). During the first year CH children growth (25.8 ± 2.8 cm/year) was similar to those for normal infants (25.5 ± 0.75 cm/year). During the first 6 years, stature growth was normal in all children with CH versus Center for disease control and prevention (CDC) data. The mean height standard deviation score (HtSDS) of children with CH showed adjustment (± 0.5 SD) toward their mid-parental height SDS (MPHtSDS) only during the second year of life. The children's mean HtSDS was higher by an average of 0.4 SD between the 2nd and 7th year of life.Conclusion:These data proved that effective screening and treatment completely assures normal neurodevelopment and linear growth in patients with CH. The data showed that their HtSDS slightly exceeds their MPHtSDS during childhood.

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Section: Discussionmentioning

confidence: 99%

Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study

Soliman¹,

Azzam²,

Elawwa³

et al. 2012

Indian J Endocr Metab

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“…Even if the CH infants today may have an even better intellectual and neurological prognosis, a subtle impairment of the neurological development and a loss in some IQ points are still detectable [5,18,19,20,21,22,23], whereas the growth is normal in all of them [9,24,25,26,27]. …”

Section: Discussionmentioning

confidence: 99%

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

et al. 2007

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Aims: To evaluate therapy and dose adjustments in patients with congenital hypothyroidism (CH), longitudinally followed up until 16 years old, according to aetiology, Beclard’s nuclei presence, and thyroxine (T4) level at diagnosis. Methods:L-T4/kg/day and dose change ratio (CR) were assessed in 74 CH patients. Results: The dose was statistically larger in athyreosis than in dyshormonogenesis (1–10 and beyond 14 years) and in ectopy (2, 15, 16 years). The ectopic children required statistically larger L-T4/kg than the dyshormonogenetic ones (3–7 years). The L-T4/kg/day was increased, not statistically, in patients or with T4 <30 nmol/l or without Beclard’s nuclei at diagnosis. The CR progressively dropped after the 6th month at each attendance, without any difference in terms of aetiology, T4 level at diagnosis, or Beclard’s nuclei. The total CR was greater (significantly) in patients without Beclard’s nuclei, and (not significantly) in those with T4 <30 nmol/l at diagnosis or with agenesia. Conclusion: The L-T4 dose in CH is highly affected by the aetiology. The CR is higher in patients with delayed bone maturation at diagnosis. We suggest that these latter patients need blood tests more frequently to obtain a proper titration of the therapy.

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“…Early and appropriate treatment during childhood and adolescence prevents the deleterious effects of TH deficiency on growth and bone maturation (86). Several studies on patients treated early for CH have reported normal height growth during childhood and normal adult height, with no effect of initial CH severity on adult height in either sex (87,88,89).…”

Section: Associated Malformations Chronic Diseases and Cardiovasculmentioning

confidence: 99%

ENDOCRINOLOGY AND ADOLESCENCE: Congenital hypothyroidism: a clinical update of long-term outcome in young adults

Léger

2015

European Journal of Endocrinology

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Congenital hypothyroidism (CH) is the most common congenital endocrine disorder. The early treatment of CH patients has successfully improved the prognosis and management of this disorder. Optimal treatment and management throughout the patient's life, beginning in the neonatal period, are required to ensure long-term health. Affected patients should be offered assessments of associated medical conditions and provided with accurate information about their condition throughout their lives, but particularly during the transition from pediatric to adult services. This review provides a summary of current knowledge about the long-term outcomes of these patients and appropriate management into early adulthood. We carried out a systematic search of the Medline database to identify relevant articles. Despite major improvements in prognosis, the impact of CH is clearly not uniform, and management should take into account a broader range of relevant indicators, including CH severity, associated comorbid conditions and the adequacy of treatment during childhood and adulthood. The early diagnosis and management of associated medical conditions, and better educational strategies to improve compliance with treatment, should improve the long-term prognosis. Further studies are required to explore changes with aging.

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Factors predicting final height in early treated congenital hypothyroid patients

Abstract: Our results, obtained in the largest reported available group of congenital hypothyroid patients, show that final height is higher than target height in both sexes and that height at onset of puberty is the main factor affecting final height.

Cited by 26 publications

References 16 publications

Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study

Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study

Longitudinal Assessment of Levo-Thyroxine Therapy for Congenital Hypothyroidism: Relationship with Aetiology, Bone Maturation and Biochemical Features

ENDOCRINOLOGY AND ADOLESCENCE: Congenital hypothyroidism: a clinical update of long-term outcome in young adults

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