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Transient congenital hypothyroidism and hyperthyrotropinemia: normal thyroid function and physical development at the
B Köhler1, D Schnabel, H Biebermann
1Department of Pediatric Endocrinology, Klinikum Rudolf Virchow, Humboldt University of Berlin, Germany.
Insights
Transient congenital hypothyroidism and hyperthyrotropinemia in children usually resolve without long-term issues. Follow-up is recommended for growth and development, with thyroid function tests if abnormalities arise.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatal screening
Background:
- Screening for congenital hypothyroidism has revealed transient thyroid function disturbances like congenital hypothyroidism and hyperthyrotropinemia.
- These transient conditions are often linked to iodine deficiency or contamination.
Purpose of the Study:
- To reevaluate thyroid function and physical development in schoolchildren previously diagnosed with transient congenital hypothyroidism or hyperthyrotropinemia.
- To determine the necessity of frequent thyroid monitoring in these children.
Main Methods:
- Retrospective analysis of 61 schoolchildren with a history of transient congenital hypothyroidism or hyperthyrotropinemia.
- Assessment of thyroid function and physical growth during follow-up evaluations.
Main Results:
- Most children showed normal thyroid function and growth.
- Two children had moderately elevated TSH levels at ages 7.7 and 10 years with normal thyroid hormones.
- One case of TSH elevation was linked to ectopic hemithyroidea, another to a familial cause. One girl developed a euthyroid goiter due to autoimmune thyroiditis.
Conclusions:
- Frequent thyroid function monitoring is generally unnecessary for children whose transient congenital hypothyroidism or hyperthyrotropinemia resolved postnatally.
- Continued monitoring of growth and development is crucial for children with a history of neonatal thyroid dysfunction.
- Thyroid function tests are essential if any developmental abnormalities are observed.
Abstract:
Since the introduction of screening programs for congenital hypothyroidism, transient disturbances of thyroid function, especially transient congenital hypothyroidism and hyperthyrotropinemia, mostly due to iodine deficiency or contamination have been observed with variable frequencies. This study was carried out to reevaluate the thyroid function and physical development of 61 schoolchildren with transient congenital hypothyroidism or transient congenital hyperthyrotropinemia. Abnormalities were observed in 3 children. Thyroid function and growth were normal in all children, except 2 with moderately elevated TSH levels at the age of 7.7 and 10 yr in the presence of normal thyroid hormone levels. In 1 child, the TSH elevation was due to an ectopic hemithyroidea; in the other child, an unknown familial cause was suggested. In 1 girl (aged 12 yr), a euthyroid goiter caused by autoimmune thyroiditis was detected. We conclude from our investigation that frequent monitoring of thyroid function in children with transient congenital hypothyroidism or transient congenital hyperthyrotropinemia is not necessary during childhood if, postnatally, thyroid function recovered spontaneously. However, the growth and development of children with neonatal thyroid dysfunction should be followed, and if abnormalities occur, thyroid function tests are essential.