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Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism

Eun Sil Park1,2, Ju Young Yoon3,4

  • 1Department of Pediatrics, Gyeongsang National University College of Medicine, Jinju, South Korea.

BMC Pediatrics
|November 23, 2019
PubMed

Insights

Higher levothyroxine doses at discontinuation may indicate permanent congenital hypothyroidism (CH). Most infants, including those discontinuing early, successfully stopped treatment, suggesting potential for earlier CH management.

Area of Science:

  • Pediatric Endocrinology
  • Neonatal Health
  • Genetics and Development

Background:

  • Congenital hypothyroidism (CH) is a common childhood endocrine disorder.
  • Distinguishing transient CH from permanent CH (PCH) is crucial for management.
  • Predictive factors for PCH and outcomes of early levothyroxine discontinuation are not well-established.

Purpose of the Study:

  • To identify predictive factors for transient CH in infants.
  • To evaluate the outcomes of early levothyroxine discontinuation in CH patients.

Main Methods:

  • Retrospective chart review of infants diagnosed with CH between 2005 and 2015.
  • Exclusion of infants with structural thyroid abnormalities.
  • Definition of an early discontinuation subgroup (levothyroxine stopped before 30 months).

Main Results:

  • Nine out of 80 infants (11.3%) had PCH.
  • PCH cases required higher levothyroxine doses at discontinuation compared to transient CH (4.3 vs 2.9 μg/kg).
  • A levothyroxine dose of 2.86 μg/kg predicted PCH with 88.9% sensitivity and 71.0% specificity.

Conclusions:

  • Most CH patients, including those discontinuing levothyroxine early, successfully managed their condition.
  • A higher levothyroxine dose at discontinuation is a significant predictive factor for PCH.
Abstract

Keywords:
Congenital hypothyroidismLevothyroxinePrognosisRisk factor

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