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Useful parameters to predict the eventual mental outcome of hypothyroid children
J Glorieux1, M Desjardins, J Letarte
1Quebec Network for Genetic Medicine, Centre Hospitalier de l'Université Laval, Ste-Foy, Canada.
Insights
Early detection of intellectual deficits in children with congenital hypothyroidism is possible. Pre-treatment indicators like low thyroxine levels and bone maturation can predict lower IQ scores, enabling timely interventions for affected infants.
Area of Science:
- Pediatric Endocrinology
- Developmental Neuroscience
Background:
- Congenital hypothyroidism requires early treatment to prevent developmental issues.
- Long-term neurodevelopmental outcomes in treated children are variable.
Purpose of the Study:
- To identify early predictors of cognitive outcomes in infants with congenital hypothyroidism.
- To assess the correlation between pre-treatment factors and later intellectual development.
Main Methods:
- Longitudinal follow-up of 100 hypothyroid children from infancy.
- Developmental assessments using Griffiths Mental Development Scales and Wechsler Intelligence Scale for Children Revised.
- Correlation analysis of pre-treatment serum thyroxine and bone maturation with cognitive scores.
Main Results:
- Children generally scored within the normal range, but some had persistently low scores.
- Pre-treatment low thyroxine and retarded bone maturation correlated with lower mental scores.
- A predictive model using these factors accurately identified 10 of 13 children with IQ < 90.
Conclusions:
- Pre-treatment thyroxine levels and bone maturation are significant predictors of cognitive development in congenital hypothyroidism.
- These factors can aid in identifying at-risk children for early intervention and tailored guidance.
Abstract:
The Quebec Network for Genetic Medicine has followed the development of some 100 hypothyroid children treated by 1 month of age and evaluated at 18 months, 3 and 5 yr and the Griffiths Mental Development Scales, then at 7 and 9 yr with the Wechsler Intelligence Scale for Children Revised. Results show that the children as a group reach scores within the normal range of the tests. However, a few patients have low scores at each evaluation. Previously, we showed a correlation between a low serum thyroxine concentration, or a relatively retarded bone maturation before treatment, and low mental scores. To better characterize the significance of this relationship we correlated these pretreatment factors and the Wechsler Intelligence Scale for Children Revised results of 43 subjects reaching the age of 7 yr. Again, the same correlation was observed. Calculating a predictive factor (low thyroxine, less than 2 micrograms/dl and retarded bone surface, less than 0.05 cm2) from data recorded before therapy initiation, 10 of 13 children were correctly predicted to have I.Q. values less than 90. The use of these parameters might permit early intervention, and allow specific guidance of the more affected subjects.