Growth, development, and reassessment of hypothyroid infants diagnosed by screening.

Hulse, J A; Grant, D B; Jackson, Doreen; Clayton, Barbara E.

doi:10.1136/bmj.284.6327.1435

Cited by 49 publications

(20 citation statements)

References 9 publications

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“…Our findings of increased TSH at 1 year in 28% of patients agree with those of Hulse et al (34% at 1 year),1Abusrewil et al (38% between 5–11 months),2and Germak and Foley (23% at 1 year) 5. The delay in the normalisation of serum TSH concentration was not influenced by the pretreatment TSH concentration nor the underlying diagnostic subtypes.…”

Section: Discussionsupporting

confidence: 90%

Factors involved in the rate of fall of thyroid stimulating hormone in treated hypothyroidism

Raza

Hindmarsh²,

Brook³

1997

Archives of Disease in Childhood

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The rate of fall of serum thyroid stimulating hormone (TSH) concentrations in 32 hypothyroid infants (11 boys, 21 girls) was studied after starting treatment with thyroxine to determine whether it was influenced by initial TSH concentration or the cause of the hypothyroidism. Of 27 patients who had isotope scans before treatment was started, 11 (40%) were athyrotic, 10 (38%) had an ectopic gland, and six (22%) probably had dyshormonogenesis. Treatment was started with thyroxine at 100 µg/m 2 /24 hours at a mean age of 26 days (range 14-45). Serum TSH concentrations remained increased in 26 (81%) at 3 months, 20 (62.5%) at 6 months, and nine (28%) at 1 year and beyond. The mean age for serum TSH to reach the normal range was 0.79 years (range 0.15-2.1 years). Diagnosis (in 27 patients) and initial results (in 32) made no diVerence to the rate of fall.

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Section: Discussionsupporting

confidence: 90%

Factors involved in the rate of fall of thyroid stimulating hormone in treated hypothyroidism

Raza

Hindmarsh²,

Brook³

1997

Archives of Disease in Childhood

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“…The treatment dosage of LT4 was similar in our two groups of children. Thus, our data do not support the view that treated CH children with high TSH levels represent low T4 levels due to undertreatment, as suggested by Hulse et al [24], or to relative undertreat ment resulting from rapid increase in body weight, as more recently suggested by Abusrewil et al [25], It is pos sible that some group B children had high TSH levels due to some lack of therapeutic compliance. However, the similar serum T4 levels in both groups, as well as the simi lar 1Q/DQ scores make a significant difference in com pliance between the two groups improbable.…”

Section: Discussioncontrasting

confidence: 54%

Early Identification of Congenital Hypothyroid Infants with Abnormalities in Pituitary Setpoint for T<sub>4</sub>-lnduced TSH Release

Eldar

Kaiserman²,

Sack³

1993

Horm Res

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It is now clear that early detection and adequate replacement therapy of congenital hypothyroidism (CH) results in normal growth and psychomotor development. However, there is evidence that some of those infants might have a persistent alteration in the T₄ feedback control of TSH release. To characterize further this phenomenon, 25 treated CH children were divided into two groups: group A consisted of children whose TSH was suppressed as early as 1 month after the onset of therapy, and group B consisted of children whose TSH suppression occurred much later. There were no differences in the etiology of CH, in the mean T₄ and T₃ serum levels or in the mean LT₄ treatment dosage between the two groups. All children were clinically euthyroid throughout the follow-up, developed according to expected norms and no deviations were noted in bone age. However, serum TSH levels remained elevated in group B infants throughout the follow-up period (up to 14 years). Increase of LT₄ treatment dosage resulted in TSH suppression in both groups. However, the TSH levels obtained in group B were still higher compared to group A. These results suggest that some CH infants might have an abnormal setpoint for T₄ control of TSH secretion and that these infants can be detected as early as 1 month after birth. Thus, serum T₄, T₃ levels and clinical progress are better guides to the adequacy of therapy than serum TSH concentrations in this group of CH infants.

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“…Early clinical findings have been given elsewhere,7 as have the results of psychometric testing at 3, 5, and 10 years of age 8-10…”

Section: Methodsmentioning

confidence: 99%

Educational progress, behaviour, and motor skills at 10 years in early treated congenital hypothyroidism

Simons

Fuggle

Grant

et al. 1997

Archives of Disease in Childhood

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Aim-To assess educational attainments, behaviour, and motor skills at 10 years of age in a group of children with congenital hypothyroidism identified by neonatal screening. Results-On all measures the congenital hypothyroidism children in group I had less satisfactory scores for educational attainments, behaviour, and motor skills than those in group II and controls. For reading the diVerences were small and did not reach statistical significance, but the deficits in mathematics and total motor skills were statistically significant (p < 0.01). There were more striking and statistically significant diVerences in behaviour scores, particularly with respect to attentional diYculties. Although less striking, these were also apparent in the group II children with mild hypothyroidism. Conclusions-At the age of 10 years severe congenital hypothyroidism is associated with some mild impairment in educational and motor attainments. Behaviour problems are also common, even in some children with less severe congenital hypothyroidism. Subjects

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Growth, development, and reassessment of hypothyroid infants diagnosed by screening.

Cited by 49 publications

References 9 publications

Factors involved in the rate of fall of thyroid stimulating hormone in treated hypothyroidism

Factors involved in the rate of fall of thyroid stimulating hormone in treated hypothyroidism

Early Identification of Congenital Hypothyroid Infants with Abnormalities in Pituitary Setpoint for T<sub>4</sub>-lnduced TSH Release

Educational progress, behaviour, and motor skills at 10 years in early treated congenital hypothyroidism

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