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[Prognostic value of bone surface in hypothyroidism detected in neonatal period]
1Service de génétique et maladies héréditaires du métabolisme de l'enfant, Hôpital Claude-Huriez, CHRU, Lille, France.
Insights
Bone maturation at diagnosis is a key prognostic factor for congenital hypothyroidism. Infants with higher bone area showed better psycho-intellectual outcomes, though verbal skills lagged behind non-verbal skills.
Area of Science:
- Pediatric Endocrinology
- Developmental Pediatrics
- Neonatal Screening
Context:
- Congenital hypothyroidism (CH) diagnosis relies on neonatal screening.
- Bone maturation at diagnosis is a potential prognostic indicator for CH.
- Assessing psycho-intellectual outcomes in CH is crucial for long-term management.
Purpose:
- To evaluate the relationship between bone maturation at diagnosis and psycho-intellectual outcomes in infants with CH.
- To compare developmental trajectories of infants with high versus low bone area at diagnosis.
- To identify factors influencing neurodevelopmental outcomes in treated CH patients.
Summary:
- This study investigated bone maturation as a prognostic factor in congenital hypothyroidism (CH).
- Infants with higher bone area at diagnosis demonstrated superior psycho-intellectual performance compared to those with lower bone area.
- While overall performance was better, verbal abilities in the high bone area group were weaker than non-verbal skills, with a few cases of IQ below 90.
Impact:
- Bone area at diagnosis can serve as a valuable prognostic marker for neurodevelopmental outcomes in CH.
- Early detection and consistent treatment adherence are vital for optimizing cognitive development in CH patients.
- Further research into specific interventions for verbal development in CH may be warranted.
Abstract:
Bone maturation at the time of diagnosis has been considered as a prognostic factor of congenital hypothyroidism. Using bone area as an index of bone maturation, we have compared the psycho-intellectual outcome of infants with high bone area (group I) at time of diagnosis, with those with low area (group II), in a population of infants with congenital hypothyroidism detected by a neonatal screening program. We found that children from group I had better performances than those from group II whatever the age of the evaluation (1, 2, 5 or 7 years). Nevertheless, the verbal performances of children from group I remained weaker than their non verbal performances and in 7 among 54, the IQ was found to be lower than 90 with a possible relationship with the thyroid insufficiency (bad compliance to treatment) in only one of them.