Levothyroxine Dosage as Predictor of Permanent and Transient Congenital Hypothyroidism: A Multicenter Retrospective Study in Japan.


Journal

Hormone research in paediatrics
ISSN: 1663-2826
Titre abrégé: Horm Res Paediatr
Pays: Switzerland
ID NLM: 101525157

Informations de publication

Date de publication:
2019
Historique:
received: 14 04 2019
accepted: 30 07 2019
pubmed: 26 9 2019
medline: 24 4 2020
entrez: 26 9 2019
Statut: ppublish

Résumé

Congenital hypothyroidism (CH) can be divided into 2 types, transient CH (T-CH) and permanent CH (P-CH), depending on the requirement of levothyroxine (LT4) for life-long treatment. Several studies have recently reported that the LT4 dosage is useful for predicting the LT4 requirement, but none of the studies followed their patients to puberty. To determine the cutoff value for the LT4 dosage as a predictor of the LT4 requirement after puberty in patients with CH. The LT4 dosage and clinical data on 99 patients with CH who were followed at the participating hospitals from the neonatal period to 15 years of age or older were retrospectively analyzed. Based on their LT4 requirement at their last hospital visit, the participants were divided into the P-CH group (n = 75), who were treated with LT4, and the T-CH group (n = 24), who were not. At age 1 year, a higher LT4 dosage was required for the P-CH group (median 3.75 vs. 2.88 µg/kg/day; p < 0.001). When the LT4 dosage cutoff value at age 1 year was set at 4.79 and 1.74 µg/kg/day, the specificity of P-CH and T-CH (for denying T-CH and P-CH, respectively) was 100 and 97%, respectively. An LT4 dosage above 4.7 µg/kg/day and below 1.8 µg/kg/day at age 1 year may help predict P-CH and T-CH, respectively.

Sections du résumé

BACKGROUND BACKGROUND
Congenital hypothyroidism (CH) can be divided into 2 types, transient CH (T-CH) and permanent CH (P-CH), depending on the requirement of levothyroxine (LT4) for life-long treatment. Several studies have recently reported that the LT4 dosage is useful for predicting the LT4 requirement, but none of the studies followed their patients to puberty.
OBJECTIVE OBJECTIVE
To determine the cutoff value for the LT4 dosage as a predictor of the LT4 requirement after puberty in patients with CH.
METHODS METHODS
The LT4 dosage and clinical data on 99 patients with CH who were followed at the participating hospitals from the neonatal period to 15 years of age or older were retrospectively analyzed. Based on their LT4 requirement at their last hospital visit, the participants were divided into the P-CH group (n = 75), who were treated with LT4, and the T-CH group (n = 24), who were not.
RESULTS RESULTS
At age 1 year, a higher LT4 dosage was required for the P-CH group (median 3.75 vs. 2.88 µg/kg/day; p < 0.001). When the LT4 dosage cutoff value at age 1 year was set at 4.79 and 1.74 µg/kg/day, the specificity of P-CH and T-CH (for denying T-CH and P-CH, respectively) was 100 and 97%, respectively.
CONCLUSIONS CONCLUSIONS
An LT4 dosage above 4.7 µg/kg/day and below 1.8 µg/kg/day at age 1 year may help predict P-CH and T-CH, respectively.

Identifiants

pubmed: 31553976
pii: 000502418
doi: 10.1159/000502418
doi:

Substances chimiques

Thyroxine Q51BO43MG4

Types de publication

Clinical Trial Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

45-51

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Tomoyo Itonaga (T)

Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan, itoyo123@oita-u.ac.jp.

Shinji Higuchi (S)

Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan.

Kazuhiro Shimura (K)

Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Keisuke Nagasaki (K)

Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Mari Satoh (M)

Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan.

Noriyuki Takubo (N)

Department of Pediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan.

Ikuko Takahashi (I)

Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan.

Hirotake Sawada (H)

Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan.

Yukihiro Hasegawa (Y)

Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

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