Three-year follow-up of children with abnormal newborn screening resultsfor congenital hypothyroidism

Collection with item attached
2017
Item details URL
http://open-repository.kisti.re.kr/cube/handle/open_repository/486253.do
DOI
10.1016/j.pedneo.2017.01.002
Title
Three-year follow-up of children with abnormal newborn screening resultsfor congenital hypothyroidism
abstract
Background: To analyze predictive factors suggesting transient congenital hypothyroidism (TCH) compared to permanent congenital hypothyroidism (PCH) or transient thyroid function test (TFT) abnormalities among children who had positive screening results at our centers over the past decade.
Methods: A retrospective chart review of 105 subjects who presented elevated TSH levels on a newborn screening test (NST) was done. TCH was defined when a trial-off therapy was successful, and PCH was defined when a trial failed or when the subject was kept on medication beyond 3 years of age. A transient TFT abnormality was defined when follow-up TFTs were normalized without levothyroxine (LT4) therapy.
Results: Congenital hypothyroidism (CH) was diagnosed in 75.2% (TCH 35.2% and PCH 40.0%) of all subjects; the others (24.8%) showed transient TFT abnormalities. Initial NST-TSH levels (optimal cutoff point, 31.0 mu IU/mL), the LT4 dose at 2 years of age (4.1 mu g/kg/day), and the maximal LT4 dose (50 mu g/day) merged as significant predictive factors discriminating between TCH and PCH. The initial serum level of free T4 (1.06 ng/dL) and not TSH (27.2 mu IU/mL) was the only discriminating factor between transient TFT abnormalities and TCH.
Conclusion: Earlier re-evaluation might be possible when a patient's initial NST-TSH levels and maximal or 2-year LT4 doses are low, as both are important predictors of successful trial-off therapy in CH patients. When the initial serum level of free T4 is above the average value in neonates with mildly elevated TSH levels, TFTs may be more likely to normalize on their own. Copyright (C) 2017, Taiwan Pediatric Association-. Published by Elsevier Taiwan LLC. This-is an open access article under the CC BY-NC-ND license
provenance
Made available in Cube on 2018-09-28T16:02:39Z (GMT). No. of bitstreams: 0
language
English
author
Kang, Min-Jae
Chung, Hye-Rim
Oh, Yeon-Joung
Shim, Young-Suk
Yang, Seung
Hwang, Il Tae
orcid
Kang, Min Jae/0000-0003-3080-0941
accessioned
2018-09-28T16:02:39Z
available
2018-09-28T16:02:39Z
issued
2017
citation
PEDIATRICS AND NEONATOLOGY(58): 5
issn
1875-9572
uri
http://open-repository.kisti.re.kr/cube/handle/open_repository/486253.do
Funder
과학기술정보통신부
Funding Program
개인기초연구(미래부)
Project ID
1711059746
Jurisdiction
Rep.of Korea
Project Name
Identification of NPR2 gene mutations and their functional characteristics in Korean children with idiopathic short stature
rights
openAccess
subject
Congenital hypotbyroidim
levothyroxine
permanent
transient
type
article


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