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Updated: Aug 16, 2026
An Ex vivo Culture System to Study Thyroid Development
Published on: June 6, 2014
Growth follow-up in 100 children with congenital hypothyroidism before and during treatment
A Chiesa1, L Gruñeiro de Papendieck, A Keselman
1Centro de Investigaciones Endocrinologicas (CEDIE), Hospital de Ninos de Buenos Aires, Argentina.
Insights
Early thyroid hormone replacement in congenital hypothyroidism (CH) is crucial. Even when treatment begins as late as 24 months, children achieve normal growth and bone age by age 5.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Congenital Hypothyroidism Management
Background:
- Congenital hypothyroidism (CH) requires timely thyroid hormone replacement to prevent developmental issues.
- The impact of delayed treatment onset on growth parameters in CH is not fully elucidated.
Purpose of the Study:
- To assess how age at treatment initiation influences growth, height, weight, head circumference, and bone age in children with CH.
- To evaluate catch-up growth and developmental outcomes up to 5 years of age.
Main Methods:
- A cohort of 100 children with CH was studied.
- Patients were grouped by age at treatment start (<2 months, 2-3, 3-6, 6-12, 12-24 months).
- Growth, weight, head circumference, and bone age (Greulich-Pyle, TW2-RUS) were monitored before and during treatment up to age 5.
Main Results:
- Pre-treatment height was significantly lower in groups treated earliest (<2 months and 2-3 months).
- Catch-up growth was observed in groups treated later (3-24 months), with no significant height differences by age 5.
- Bone age normalized by age 5 in all groups; head circumference was less affected than height.
Conclusions:
- Thyroid hormone replacement for CH, even when initiated up to 24 months, effectively corrects short stature and delayed bone age by age 5.
- Catch-up growth is achievable, indicating the importance of consistent hormone therapy.
- Midparental height is a significant predictor of final height in treated CH patients.
Abstract:
In order to assess the influence of age at onset of treatment on subsequent growth, height, weight, head circumference (HC) and bone age as estimated by Greulich-Pyle and TW2-RUS methods, 100 children with congenital hypothyroidism (CH) were studied before and during adequate treatment up to 5 years of age. The patients were divided into five groups according to age at the start of treatment: Group 1: < 2 months (n = 26); Group 2: 2-3 months (n = 13); Group 3: 3-6 months (n = 21); Group 4: 6-12 months (n = 20); Group 5: 12-24 months (n = 20). Before treatment, groups 1 and 2 differed significantly from the others in height (p < 0.001). With hormone therapy, catch-up growth was observed in groups 3 to 5, but at age 5 years no differences were found between groups. In all groups, height at 5 years of age correlated significantly with children's midparental height (p < 0.002). Bone age was initially retarded in groups 3 to 5, but approximated the chronological age by age 5 years. Initially, HC was less affected than height and remained relatively larger up to age 5 years in all groups. These findings show that thyroid hormone replacement in CH as late as 24 months corrects the short stature and delayed bone age by age 5 years.