ESPEYB16 3. Thyroid Congenital Hypothyroidism (3 abstracts)
3.9. Early determinants of thyroid function outcomes in children with congenital hypothyroidism and a normally located thyroid gland: a regional Cohort Study
Saba C , Guilmin-Crepon S , Zénaty D , Martinerie L , Paulsen A , Simon D , Storey C , Dos Santos S , Haignere J , Mohamed D , Carel JC & Léger J
To read the full abstract: Thyroid. 2018;28:959–67.
This observational single center study aimed to identify predictors of transient versus permanent congenital hypothyroidism in patients with thyroid gland in situ diagnosed at birth. Strengths of the study are the prospectively documented clinical, biochemical and radiological parameters, the high inclusion rate, and the detailed outcome data during follow-up.
In a multivariate analysis, the authors identified one main predictor of transient congenital hypothyroidism: levothyroxine dose at 6 months <3.2 microgram/kg/d had a sensitivity of 71% and a specificity of 79% for predicting transient hypothyroidism. These results are the first to provide discriminative levothyroxine doses under treatment at such an early time point of life to distinguish between patients with transient forms versus permanent congenital hypothyroidism. Further, the findings show no evidence to support other often reported predictors, such as initial biochemical severity of congenital hypothyroidism, and thyroid morphology.
If validated prospectively, we as clinicians will get a new tool to trial-off patients from levothyroxine treatment much earlier than currently recommended. However, as stated by the authors, the long-term outcome of the transient disease group after ‘apparent’ successful discontinuation of substitutive therapy remains to be ascertained.
Volume 16
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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