Akademik Veri Yönetim Sistemi
ESPE 2022, Rome, İtalya, 15 - 17 Eylül 2022, ss.421, (Özet Bildiri)
Objective: The incidence of congenital hypothyroidism (CH)
has increased worldwide. Lowering cut-off in screening programs
has led to an increase in the rate of transient CH. We aimed to
evaluate the rates of permanent and transient CH in cases referred
from the screening program and to investigate the clinical and laboratory factors to predict the transient CH.
Methods: 109 cases referred from the screening program to our
hospital, from September 2015 to April 2018, and 52 cases were
diagnosed with CH. Those cases were prospectively evaluated and
cases completed regular 3-years-follow up (n=44) were reinvestigated to determine the rates of permanent and transient CH.
Results: Fifteen cases (34%) were diagnosed with permanent
CH and 29 cases (66%) were diagnosed with transient CH.
Gestational age in weeks (w) and birth weight were 38.2 ± 1.31 and
3021.3 ± 389.6 gram (g) in the transient CH group and both were
significantly lower compared to permanent CH cases with the
results of 39.06 ± 1.33 w and 3375,3 ± 425,3 g (P=0.025, p=0.007).
Transient CH rate was found to be 50 % (all hypoplastic) in the
dysgenesis group and 73.3% together in groups with the normal
and hyperplasic thyroid gland. While fT4, thyroid-stimulating
hormone, and thyroglobulin levels at diagnosis do not predict
transient/permanent CH, levothyroxine (LT-4) dosage was significantly lower in the transient CH group in all years. The optimal
cut-off value with highest sensitivity and specificity for LT-4 dosage as a predictive marker to differentiate transient CH from permanent CH was found 2.27 µg/kg/day (P=0.004; sensitivity: 71%,
specificity: 83%) at 1st year, 1.85 µg /kg/day (P=0.013; sensitivity:
66%, specificity: 72%) at 2nd year and 1.69 µg /kg/day at 3rd year
(P<0.0001; sensitivity: 90%, specificity: 83%).
Conclusion: Transient CH is more frequent than expected. Our
results suggest that the LT-4 requirement may be a good marker
for predicting transient CH. Therefore, infants with CH requiring
LT-4 doses <2.27 μg/kg/day at 1st year, <1.85 μg /kg/day at 2nd
year may be re-evaluated earlier to discriminate transient CH.