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Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran

BACKGROUND: Primary congenital hypothyroidism (CH) is the most common treatable cause of mental retardation and can be classified into permanent and transient types. The purpose of this study was to determine the prevalence of permanent and transient congenital hypothyroidism (CH) in Hamadan, West p...

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Autores principales: Razavi, Zahra, Mohammadi, Lida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253200/
https://www.ncbi.nlm.nih.gov/pubmed/28144251
http://dx.doi.org/10.5812/ijem.38256
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author Razavi, Zahra
Mohammadi, Lida
author_facet Razavi, Zahra
Mohammadi, Lida
author_sort Razavi, Zahra
collection PubMed
description BACKGROUND: Primary congenital hypothyroidism (CH) is the most common treatable cause of mental retardation and can be classified into permanent and transient types. The purpose of this study was to determine the prevalence of permanent and transient congenital hypothyroidism (CH) in Hamadan, West province of Iran. METHODS: The study population included all cases with primary congenital hypothyroidism, which were confirmed by thyroid function tests (TSH levels ≥ 10 mIU/L). All these patients had been followed up at the outpatient pediatric endocrine clinic of Besat hospital (Hamadan, Iran) for a period of time between May 2006 and March 2013. Biochemical findings at diagnosis and detailed medical records were collected. Patients were considered as permanent hypothyroidism if their TSH level was 10 (mIU/l) during 6 - 12 months of treatment. Also three years old patients with TSH level > 10 mU/L during one or three months after discontinuation of levothyroxine treatment were considered as permanent hypothyroidism. RESULTS: A total of 164 children (49.9% male and 50.6% female) diagnosed with CH completed the study. Female/male ratio was 1.02/1. The incidence of CH was about 1/1250 in Hamadan, West province of Iran. Of the 164 patients, 105 cases (64 %) were diagnosed as permanent CH and other 59 cases (36%) were proven to have transient hypothyroidism. Female to male ratio was 1.14 in patients suffering from permanent CH and 0.8 in patients with transient CH. The initial TSH level was found to be significantly higher in cases with permanent CH compared to the patients with transient CH (P = 0.001). Mean TSH level during the first year of treatment was higher in permanent CH cases compared to transient cases (P = 0.001). Children with transient CH had a lower TSH serum level during the three years of treatment (P = 0.000). A significant statistical difference was not found between the genders and permanent or transient CH (P = 0.352). Co-occurring congenital anomalies and birth order were significantly different between two groups (P = 0.028 and P = 0.024, respectively). CONCLUSIONS: Our regional follow-up data showed that about 40% of newborns with primary CH had transient thyroid dysfunction. Our results further clarify our previous research by providing evidences on the incidence rate of CH. The incidence rates of CH as well as transient type of CH in our region were higher than those reported by other studies which have been conducted in other regions of the world. The initial TSH level was the strongest predictor of treatment cessation. Given the high incidence of transient CH in our region, further studies are needed to confirm the etiology and to provide considerable insight into preventive and/or the treatment strategies.
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spelling pubmed-52532002017-01-31 Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran Razavi, Zahra Mohammadi, Lida Int J Endocrinol Metab Research Article BACKGROUND: Primary congenital hypothyroidism (CH) is the most common treatable cause of mental retardation and can be classified into permanent and transient types. The purpose of this study was to determine the prevalence of permanent and transient congenital hypothyroidism (CH) in Hamadan, West province of Iran. METHODS: The study population included all cases with primary congenital hypothyroidism, which were confirmed by thyroid function tests (TSH levels ≥ 10 mIU/L). All these patients had been followed up at the outpatient pediatric endocrine clinic of Besat hospital (Hamadan, Iran) for a period of time between May 2006 and March 2013. Biochemical findings at diagnosis and detailed medical records were collected. Patients were considered as permanent hypothyroidism if their TSH level was 10 (mIU/l) during 6 - 12 months of treatment. Also three years old patients with TSH level > 10 mU/L during one or three months after discontinuation of levothyroxine treatment were considered as permanent hypothyroidism. RESULTS: A total of 164 children (49.9% male and 50.6% female) diagnosed with CH completed the study. Female/male ratio was 1.02/1. The incidence of CH was about 1/1250 in Hamadan, West province of Iran. Of the 164 patients, 105 cases (64 %) were diagnosed as permanent CH and other 59 cases (36%) were proven to have transient hypothyroidism. Female to male ratio was 1.14 in patients suffering from permanent CH and 0.8 in patients with transient CH. The initial TSH level was found to be significantly higher in cases with permanent CH compared to the patients with transient CH (P = 0.001). Mean TSH level during the first year of treatment was higher in permanent CH cases compared to transient cases (P = 0.001). Children with transient CH had a lower TSH serum level during the three years of treatment (P = 0.000). A significant statistical difference was not found between the genders and permanent or transient CH (P = 0.352). Co-occurring congenital anomalies and birth order were significantly different between two groups (P = 0.028 and P = 0.024, respectively). CONCLUSIONS: Our regional follow-up data showed that about 40% of newborns with primary CH had transient thyroid dysfunction. Our results further clarify our previous research by providing evidences on the incidence rate of CH. The incidence rates of CH as well as transient type of CH in our region were higher than those reported by other studies which have been conducted in other regions of the world. The initial TSH level was the strongest predictor of treatment cessation. Given the high incidence of transient CH in our region, further studies are needed to confirm the etiology and to provide considerable insight into preventive and/or the treatment strategies. Kowsar 2016-10-19 /pmc/articles/PMC5253200/ /pubmed/28144251 http://dx.doi.org/10.5812/ijem.38256 Text en Copyright © 2016, Research Institute For Endocrine Sciences and Iran Endocrine Society http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Research Article
Razavi, Zahra
Mohammadi, Lida
Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title_full Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title_fullStr Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title_full_unstemmed Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title_short Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran
title_sort permanent and transient congenital hypothyroidism in hamadan west province of iran
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253200/
https://www.ncbi.nlm.nih.gov/pubmed/28144251
http://dx.doi.org/10.5812/ijem.38256
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