Update on congenital hypothyroidism.
Journal
Current opinion in endocrinology, diabetes, and obesity
ISSN: 1752-2978
Titre abrégé: Curr Opin Endocrinol Diabetes Obes
Pays: England
ID NLM: 101308636
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
pubmed:
4
12
2019
medline:
25
11
2020
entrez:
3
12
2019
Statut:
ppublish
Résumé
The present review summarizes recent advances in the diagnosis and management of patients with congenital hypothyroidism. Although most newborn screening strategies are designed to detect severe primary hypothyroidism that presents shortly after birth, some infants display a pattern of delayed TSH rise despite normal initial newborn screening. Recent studies suggest that delayed TSH rise may be more common and more severe than previously recognized. Although much less common than primary hypothyroidism, central congenital hypothyroidism is as likely to be of moderate or severe degree, which has implications for its detection and treatment. The discovery of new genetic causes of central congenital hypothyroidism, including the X-linked genes IGSF1, TBL1X, and IRS4, has begun to expand our understanding of thyroid axis regulation. Recent long-term data indicate that current treatment recommendations for congenital hypothyroidism result in grossly normal neurocognitive outcomes even in severely affected patients, and that overtreatment may not be as harmful as previously suspected. Liquid levothyroxine is now commercially available in the United States, but more studies are needed to determine optimal dosing using this formulation. Prompt identification and adequate treatment of patients with congenital hypothyroidism is critical to optimize outcomes. New information continues to accumulate about how to improve detection of congenital hypothyroidism in specific subgroups of infants (particularly those with delayed TSH rise and central hypothyroidism) and about treatment of patients with this disorder.
Identifiants
pubmed: 31789720
doi: 10.1097/MED.0000000000000520
pii: 01266029-202002000-00012
doi:
Substances chimiques
Thyrotropin
9002-71-5
Thyroxine
Q51BO43MG4
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-69Références
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