Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses
PurposeThe incidence of congenital hypothyroidism (CH) has increased in several countries. Lower cut-off in screening programs have led to an increase in the proportion of transient hypothyroidism (TH) cases diagnosed, leading to debate on the associated clinical and economic impact. This study aime...
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| Format: | Article |
| Language: | English |
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Korean Society of Pediatric Endocrinology
2014-09-01
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| Series: | Annals of Pediatric Endocrinology & Metabolism |
| Subjects: | |
| Online Access: | http://e-apem.org/upload/pdf/apem-19-141.pdf |
| _version_ | 1831523838676959232 |
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| author | Min Sun Cho Gyung Sun Cho So Hyun Park Min Ho Jung Byung Kyu Suh Dae Gyun Koh |
| author_facet | Min Sun Cho Gyung Sun Cho So Hyun Park Min Ho Jung Byung Kyu Suh Dae Gyun Koh |
| author_sort | Min Sun Cho |
| collection | DOAJ |
| description | PurposeThe incidence of congenital hypothyroidism (CH) has increased in several countries. Lower cut-off in screening programs have led to an increase in the proportion of transient hypothyroidism (TH) cases diagnosed, leading to debate on the associated clinical and economic impact. This study aimed to identify factors that would allow discrimination between TH and permanent CH (PH) in patients with a eutopic thyroid gland.MethodsSixty-six patients with CH from 3 different hospitals were studied: 26 cases of TH, and 40 cases of PH. Laboratory findings and clinical parameters were analysed in 56 patients with eutopic thyroid gland.ResultsInitial serum thyroid stimulating hormone levels and L-thyroxine dose at 12 and 24 months of age were significantly higher in PH than TH patients with a eutopic thyroid gland. The area under the curve for the 12-month and 24-month dose for the prediction of TH in eutopic CH was 0.799 (95% confidence interval [CI], 0.678-0.919; P<0.001) and 0.925 (95% CI, 0.837-1.000; P<0.001), respectively. The optimum 12-month and 24-month dose in predicting TH is 3.25 µg/kg (12-month: sensitivity, 87.1%; specificity, 68.0%; 24-month: sensitivity 93.5%, specificity 88%).ConclusionInfants with CH requiring lower L-thyroxine doses (<3.25 µg/kg) are likely to have TH, and thus might be re-evaluated at 12 months or 24 months rather than 3 years of age. |
| first_indexed | 2024-12-14T19:43:45Z |
| format | Article |
| id | doaj.art-c059d78453e24e3cb1091b7062579498 |
| institution | Directory Open Access Journal |
| issn | 2287-1012 2287-1292 |
| language | English |
| last_indexed | 2024-12-14T19:43:45Z |
| publishDate | 2014-09-01 |
| publisher | Korean Society of Pediatric Endocrinology |
| record_format | Article |
| series | Annals of Pediatric Endocrinology & Metabolism |
| spelling | doaj.art-c059d78453e24e3cb1091b70625794982022-12-21T22:49:38ZengKorean Society of Pediatric EndocrinologyAnnals of Pediatric Endocrinology & Metabolism2287-10122287-12922014-09-0119314114510.6065/apem.2014.19.3.141542Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine dosesMin Sun Cho0Gyung Sun Cho1So Hyun Park2Min Ho Jung3Byung Kyu Suh4Dae Gyun Koh5Department of Pediatrics, The Catholic University of Korea, St. Paul's Hospital, Seoul, Korea.Department of Pediatrics, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.Department of Pediatrics, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.Department of Pediatrics, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.Department of Pediatrics, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.PurposeThe incidence of congenital hypothyroidism (CH) has increased in several countries. Lower cut-off in screening programs have led to an increase in the proportion of transient hypothyroidism (TH) cases diagnosed, leading to debate on the associated clinical and economic impact. This study aimed to identify factors that would allow discrimination between TH and permanent CH (PH) in patients with a eutopic thyroid gland.MethodsSixty-six patients with CH from 3 different hospitals were studied: 26 cases of TH, and 40 cases of PH. Laboratory findings and clinical parameters were analysed in 56 patients with eutopic thyroid gland.ResultsInitial serum thyroid stimulating hormone levels and L-thyroxine dose at 12 and 24 months of age were significantly higher in PH than TH patients with a eutopic thyroid gland. The area under the curve for the 12-month and 24-month dose for the prediction of TH in eutopic CH was 0.799 (95% confidence interval [CI], 0.678-0.919; P<0.001) and 0.925 (95% CI, 0.837-1.000; P<0.001), respectively. The optimum 12-month and 24-month dose in predicting TH is 3.25 µg/kg (12-month: sensitivity, 87.1%; specificity, 68.0%; 24-month: sensitivity 93.5%, specificity 88%).ConclusionInfants with CH requiring lower L-thyroxine doses (<3.25 µg/kg) are likely to have TH, and thus might be re-evaluated at 12 months or 24 months rather than 3 years of age.http://e-apem.org/upload/pdf/apem-19-141.pdfCongenital hypothyroidismThyroxineThyroid gland |
| spellingShingle | Min Sun Cho Gyung Sun Cho So Hyun Park Min Ho Jung Byung Kyu Suh Dae Gyun Koh Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses Annals of Pediatric Endocrinology & Metabolism Congenital hypothyroidism Thyroxine Thyroid gland |
| title | Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses |
| title_full | Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses |
| title_fullStr | Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses |
| title_full_unstemmed | Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses |
| title_short | Earlier re-evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower L-thyroxine doses |
| title_sort | earlier re evaluation may be possible in pediatric patients with eutopic congenital hypothyroidism requiring lower l thyroxine doses |
| topic | Congenital hypothyroidism Thyroxine Thyroid gland |
| url | http://e-apem.org/upload/pdf/apem-19-141.pdf |
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