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Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism

BACKGROUND: Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 ye...

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Autores principales: Park, Eun Sil, Yoon, Ju Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873549/
https://www.ncbi.nlm.nih.gov/pubmed/31752783
http://dx.doi.org/10.1186/s12887-019-1833-8
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author Park, Eun Sil
Yoon, Ju Young
author_facet Park, Eun Sil
Yoon, Ju Young
author_sort Park, Eun Sil
collection PubMed
description BACKGROUND: Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation. METHODS: We gathered data regarding infants diagnosed with CH between July 2005 and July 2015 by retrospective chart review. Those with aplastic, hypoplastic or ectopic glands on thyroid ultrasonography or scan were excluded. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age. RESULTS: From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 μg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH (3.8 vs 2.5 μg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 μg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine. CONCLUSION: The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH.
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spelling pubmed-68735492019-11-25 Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism Park, Eun Sil Yoon, Ju Young BMC Pediatr Research Article BACKGROUND: Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation. METHODS: We gathered data regarding infants diagnosed with CH between July 2005 and July 2015 by retrospective chart review. Those with aplastic, hypoplastic or ectopic glands on thyroid ultrasonography or scan were excluded. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age. RESULTS: From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 μg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH (3.8 vs 2.5 μg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 μg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine. CONCLUSION: The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH. BioMed Central 2019-11-22 /pmc/articles/PMC6873549/ /pubmed/31752783 http://dx.doi.org/10.1186/s12887-019-1833-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Park, Eun Sil
Yoon, Ju Young
Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title_full Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title_fullStr Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title_full_unstemmed Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title_short Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
title_sort factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873549/
https://www.ncbi.nlm.nih.gov/pubmed/31752783
http://dx.doi.org/10.1186/s12887-019-1833-8
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