How Should We Be Treating Children with Congenital Hypothyroidism?

@article{Lafranchi2007HowSW,
  title={How Should We Be Treating Children with Congenital Hypothyroidism?},
  author={Stephen H Lafranchi and Juliana Austin},
  journal={Journal of Pediatric Endocrinology and Metabolism},
  year={2007},
  volume={20},
  pages={559 - 578}
}
Early detection by newborn screening and appropriate L-thyroxine treatment leads to normal or near-normal neurocognitive outcome in infants with congenital hypothyroidism. Many newborns with congenital hypothyroidism have some residual thyroid hormone production, and even in those with athyreosis, transplacental passage of maternal thyroid hormone offers some protection for a time. Given the serum T4 half-life of 6 days, the neonatal T4 level will fall and disappear over the first 2-3 weeks of… Expand
Approach to the diagnosis and treatment of neonatal hypothyroidism.
  • S. Lafranchi
  • Medicine
  • The Journal of clinical endocrinology and metabolism
  • 2011
TLDR
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TLDR
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Congenital Hypothyroidism is one of the most common preventable cause of mental retardation in children. Usually this disease is caused by an abnormal development of thyroid gland also called asExpand
Congenital hypothyroidism: current perspectives
TLDR
The lower screening thyroid stimulating hormone (TSH) cutoff and changes in birth demographics in some countries have been associated with an increase in the reported incidence of CH, however, the additional cases detected by the lower TSH cutoff tend to have either milder or transient hypothyroidism. Expand
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References

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TLDR
Efforts are ongoing to establish the optimal therapy that leads to maximum potential for normal development for infants with congenital hypothyroidism, as well as to maintain frequent evaluations of total Thyroxine or free thyroxine in the upper half of the reference range during the first 3 years of life. Expand
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TLDR
It is concluded that with earlier treatment and a higher initial dose of levothyroxine, the early developmental outcome of infants with severe congenital hypothyroidism is now indistinguishable from that of infant with the moderate form of the disease who were used as controls. Expand
Outcome of Lower L-Thyroxine Dose for Treatment of Congenital Hypothyroidism
TLDR
Average range IQ scores and positive behavioral adaptation are observed in congenitally hypothyroid children treated with L-thyroxine doses lower than currently recommended, and the L- thyroxine dose should be individualized to prevent iatrogenic hyperthyroidism. Expand
Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism.
TLDR
The data suggest that optimal treatment includes achievement of euthyroidism before the third week of life by initiation of therapy before 13 days with a levothyroxine dose above 9.5 microg/kg/d and maintenance of FT(4) concentrations in the upper normal range during the first year. Expand
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TLDR
In children with CH serum TSH can be suppressed to normal or even subnormal concentrations provided that enough L-T4 is given to maintain FT4 in the upper half of the normal range or slightly higher, and sporadic elevations of TSH during treatment are studied. Expand
Sixty children with congenital hypothyroidism detected by neonatal thyroid: mental development at 1, 4, and 7 years: a longitudinal study.
TLDR
There are no significant DQ/IQ differences neither between athyroidism and ectopic thyroid glands, nor between prenatal bone age and normal skeletal maturation at diagnosis, and it is assumed that the favourable results in children with C.H. may be ascribed to the early onset of thyroid hormone replacement and the strictly controlled compliance. Expand
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TLDR
When initiating soy-formula feeding in infants with congenital hypothyroidism, the L-thyroxine dose should be increased because of significant reduction in intestinal absorption: conversely, when soy feeding is discontinued, theL- thyroxine doses should be decreased. Expand
Longitudinal assessment of L-thyroxine therapy for congenital hypothyroidism.
TLDR
It is concluded that the prompt restoration of clinical and biochemical euthyroidism during early infancy with doses of L-thyroxine between 10 and 14 micrograms/kg/day is a safe and effective method of therapy for children with congenital hypothyroidism. Expand
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TLDR
It is concluded that in infants with severe congenital hypothyroidism, substantial amounts of T4 are transferred from mother to fetus during late gestation. Expand
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A controlled longitudinal prospective study is reported of physical and neuropsychological progress up to 12 years in 152 children with congenital hypothyroidism (CH), detected by newborn screeningExpand
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