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Thyroid function in term newborn infants with congenital goiter
Insights
Congenital goiter in newborns can indicate subtle hypothyroidism, even with normal bone age. Early thyroid hormone treatment is crucial for brain development and goiter regression.
Area of Science:
- Neonatal endocrinology
- Pediatric thyroid disorders
Background:
- Congenital goiter presents a diagnostic challenge in newborns.
- Thyroid dysfunction in infancy can impact neurodevelopment.
Purpose of the Study:
- To evaluate thyroid function and bone maturation in infants with congenital goiter.
- To identify subtle hypothyroidism in newborns with congenital goiter.
Main Methods:
- Assessed thyroid function tests (TSH, T4I, PBI, TBI) in 45 infants with congenital goiter.
- Radiologically evaluated bone age (femoral and tibial epiphyses).
- Compared findings with 84 healthy term newborns.
Main Results:
- 58% of infants with congenital goiter showed retarded bone age and biochemical evidence of hypothyroidism (elevated TSH, TBI; decreased T4I, PBI).
- 42% had normal bone age and biochemical parameters, except for elevated TBI.
- Subtle hypothyroidism was identified in a significant portion of infants.
Conclusions:
- Newborns with congenital goiter and subtle hypothyroidism require thyroid hormone substitution to prevent potential brain development retardation.
- Even without biochemical hypothyroidism, thyroid hormone treatment aids rapid goiter regression.
Abstract:
Eighty-four term newborn infants without goiter and 45 newborn infants with congenital goiter were studied with regard to thyroid function. The radiologic development of the femoral and tibial epiphyses was evaluated in those with goiter. Fifty-eight percent of the patients had retarded bone age, markedly elevated TSH levels, elevated TBI, decreased total T4I, and decreased PBI values. Forty-two percent of newborn infants with congenital goiter had a normal bone age, normal values for TSH, PBI, and total T4I, and elevated values for TBI. It is concluded that the 58% of the newborn infants with congenital goiter had subtle hypothyroidism. They require substitution therapy with thyroid hormones in order to avoid possible retardation of normal brain development. Patients with congenital goiter who have no biochemical evidence of hypothyroidism should also be treated with thyroid hormones to achieve rapid regression of goiter.