L-thyroxin treatment in infants with hyperthyrotropinaemia: 4-year experience

Area of Science:

• Pediatric Endocrinology
• Neonatal Screening
• Thyroid Function

Background:

• Hyperthyrotropinaemia (elevated TSH with normal T4) is often detected via neonatal screening.
• The optimal follow-up and treatment strategy for persistent hyperthyrotropinaemia remain undefined.
• This condition can present with prolonged high TSH levels in some individuals.

Purpose of the Study:

• To evaluate the outcomes of a 4-year follow-up for 36 infants with hyperthyrotropinaemia.
• To assess the efficacy and safety of low-dose L-thyroxine treatment in this cohort.
• To determine the long-term developmental trajectory of infants with hyperthyrotropinaemia.

Main Methods:

• Retrospective analysis of 36 cases of hyperthyrotropinaemia over 4 years.
• Treatment with low-dose L-thyroxine (5 microg/kg/day) initiated for TSH levels ≥5 mU/l and exaggerated TRH response.
• Dose adjustments, monitoring for biochemical hyperthyroidism, and Denver developmental assessment at age 3.

Main Results:

• Low-dose L-thyroxine treatment was administered to 36 patients.
• The L-thyroxine dose was reduced in 24 patients within 6 months.
• Three patients discontinued treatment due to biochemical hyperthyroidism; all patients demonstrated normal age-appropriate development.

Conclusions:

• Long-term regular follow-up is essential for infants diagnosed with hyperthyrotropinaemia.
• Individualized, low-dose L-thyroxine therapy may be beneficial for some patients.
• Early intervention and monitoring support normal neurodevelopmental outcomes in treated infants.