Diagnostic Re-evaluation of Children with Congenital Hypothyroidism.
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Date
2010-09
Journal Title
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Abstract
Objectives: To investigate the causes of congenital
hypothyroidism in children more than 3 years of age and to
document the frequency of transient vs permanent
hypothyroidism.
Design: Hospital based observational study.
Setting: Pediatric endocrine clinic of a medical college.
Patients: Children over 3 years of age, on treatment for
congenital hypothyroidism.
Intervention: Thyroid function test (TFT) and thyroid
ultrasound was done. Children with agenesis or
hemiagenesis in thyroid ultrasound were identified. In
children with normal or equivocal thyroid ultrasound,
thyroxine was stopped and followed. Children with
abnormal TFT on follow up had thyroid scintigraphy with or
without potassium perchlorate discharge, after which,
thyroid hormone supplement was restarted. Children who
remained euthyroid on follow up were labeled as having
transient hypothyroidism.
Main Outcome Measure: Proportion of children with
transient hypothyroidism.
Results: Among 36 children studied (20 boys and 16
girls), eighteen (50%) had transient hypothyroidism and
fifteen (41.7%) had thyroid agenesis. There was one with
hemiagenesis, one with ectopic thyroid and another with
dyshormonogenesis (2.8% each). Initial TSH level at the
time of diagnosis was higher in permanent hypothyroidism
as compared with transient group (83.0 ± 31.6 vs 47.0 ±
33.1 mIU/mL; P= 0.002).
Conclusions: Thyroid hormone supplementation could
be discontinued in 50% of children diagnosed with
congenital hypothyroidism.
Description
Keywords
Children, Congenital hypothyroidism, Etiology, Transient hypothyroidism, India
Citation
Nair Priya S, Sobhakumar S, Kailas Lalitha. Diagnostic Re-evaluation of Children with Congenital Hypothyroidism. Indian Pediatrics. 2010 Sept; 47(9): 757-760.