open access

Vol 70, No 1 (2019)
Original papers
Published online: 2018-10-30
Submitted: 2018-07-12
Accepted: 2018-09-27
Get Citation

Thyroid scintigraphy in three-year-old children with congenital hypothyroidism in correlation with neonatal TSH

Majid Aminzadeh
DOI: 10.5603/EP.a2018.0083
·
Pubmed: 30450534
·
Endokrynologia Polska 2019;70(1):43-48.

open access

Vol 70, No 1 (2019)
Original papers
Published online: 2018-10-30
Submitted: 2018-07-12
Accepted: 2018-09-27

Abstract

Introduction: A large number of congenital hypothyroidism (CH) cases in Iran are transient. This study was designed to investigate the aetiology of permanent CH (PCH) by thyroid scintigraphy (TS) and its relationship with the first diagnostic thyrotropin (TSH).
Material and methods: During 12 years (2005–2017) of CH screening in southwest Iran, all infants referred with the diagnosis of CH were followed until their third birthday, when they were re-evaluated for serum T4, TSH after discontinuing the treatment for 3–4 weeks. If the last test indicated a PCH state (TSH >10 mU/L with any levels of T4), TS was performed, and, based on the results, the patients were categorised as agenesis, dysgenesis (sublingual, thyroglossal cyst), and normal/diffuse goitre (indicating dyshormonogenesis).
Results: After excluding all transient CH subjects, 224 permanent CH cases were enrolled (52.7% female). Seasonal distributions were as follows: spring: 25.7%, summer: 27.9%, autumn: 20.3%, and winter: 26.1%. No significant differences were found between females and males and the different modes of delivery (55.4% were delivered by caesarean section) regarding T4, TSH (p > 0.05). Of a total of 213 performed scans, 20.7% had agenesis, 36.2% had dysgenesis, and 43.2% were normal or goitrous. Those with agenesis/dysgenetic thyroid
had a lower T4 and a higher TSH than those with normal scans. However, the differences were not significant. Compared to those who had TSH < 40 mU/L, patients with TSH ≥ 40mU/L had 46% (95% CI: 1.06–2.02) more risk of agenesis or dysgenesis in TS.
Conclusions: More than 40% of PCH are caused by dyshormonogenesis in Iran. Having a TSH ≥ 40 mU/L after the first week of life significantly raises the probability of thyroid agenesis/dysgenesis as the cause.

Abstract

Introduction: A large number of congenital hypothyroidism (CH) cases in Iran are transient. This study was designed to investigate the aetiology of permanent CH (PCH) by thyroid scintigraphy (TS) and its relationship with the first diagnostic thyrotropin (TSH).
Material and methods: During 12 years (2005–2017) of CH screening in southwest Iran, all infants referred with the diagnosis of CH were followed until their third birthday, when they were re-evaluated for serum T4, TSH after discontinuing the treatment for 3–4 weeks. If the last test indicated a PCH state (TSH >10 mU/L with any levels of T4), TS was performed, and, based on the results, the patients were categorised as agenesis, dysgenesis (sublingual, thyroglossal cyst), and normal/diffuse goitre (indicating dyshormonogenesis).
Results: After excluding all transient CH subjects, 224 permanent CH cases were enrolled (52.7% female). Seasonal distributions were as follows: spring: 25.7%, summer: 27.9%, autumn: 20.3%, and winter: 26.1%. No significant differences were found between females and males and the different modes of delivery (55.4% were delivered by caesarean section) regarding T4, TSH (p > 0.05). Of a total of 213 performed scans, 20.7% had agenesis, 36.2% had dysgenesis, and 43.2% were normal or goitrous. Those with agenesis/dysgenetic thyroid
had a lower T4 and a higher TSH than those with normal scans. However, the differences were not significant. Compared to those who had TSH < 40 mU/L, patients with TSH ≥ 40mU/L had 46% (95% CI: 1.06–2.02) more risk of agenesis or dysgenesis in TS.
Conclusions: More than 40% of PCH are caused by dyshormonogenesis in Iran. Having a TSH ≥ 40 mU/L after the first week of life significantly raises the probability of thyroid agenesis/dysgenesis as the cause.

Get Citation

Keywords

congenital hypothyroidism; screening; thyroid dysgenesis; thyroid scintigraphy

About this article
Title

Thyroid scintigraphy in three-year-old children with congenital hypothyroidism in correlation with neonatal TSH

Journal

Endokrynologia Polska

Issue

Vol 70, No 1 (2019)

Pages

43-48

Published online

2018-10-30

DOI

10.5603/EP.a2018.0083

Pubmed

30450534

Bibliographic record

Endokrynologia Polska 2019;70(1):43-48.

Keywords

congenital hypothyroidism
screening
thyroid dysgenesis
thyroid scintigraphy

Authors

Majid Aminzadeh

References (24)
  1. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010; 5: 17.
  2. Karamizadeh Z, Dalili S, Sanei-Far H, et al. Does congenital hypothyroidism have different etiologies in Iran? Iran J Pediatr. 2011; 21(2): 188–192.
  3. Hashemipour M, Hovsepian S, Kelishadi R. Permanent and transient congenital hypothyroidism in Isfahan-Iran. J Med Screen. 2009; 16(1): 11–16.
  4. Hashemipour M, Nasri P, Hovsepian S, et al. Urine and milk iodine concentrations in healthy and congenitally hypothyroid neonates and their mothers. Endokrynol Pol. 2010; 61(4): 371–376.
  5. Parks JS, Lin M, Grosse SD, et al. The impact of transient hypothyroidism on the increasing rate of congenital hypothyroidism in the United States. Pediatrics. 2010; 125(Suppl 2): S54–S63.
  6. Aminzadeh M, Chomeili B, Riahi K, et al. Effect of temperature changes on the occurrence of congenital hypothyroidism. J Med Screen. 2010; 17(3): 121–124.
  7. Kanike N, Davis A, Shekhawat PS. Transient hypothyroidism in the newborn: to treat or not to treat. Transl Pediatr. 2017; 6(4): 349–358.
  8. Zinn AB. Inborn errors of metabolism. In: Martin RJ, Fanaroff AA, Walsh MC. ed. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 9 ed. . Elsevier Mosby, St. Louis 2011: 1621.
  9. Schoen EJ, Clapp W, To TT, et al. The key role of newborn thyroid scintigraphy with isotopic iodide (123I) in defining and managing congenital hypothyroidism. Pediatrics. 2004; 114(6): e683–e688.
  10. Park SM, Chatterjee VKK. Genetics of congenital hypothyroidism. J Med Genet. 2005; 42(5): 379–389.
  11. Iranpour R, Hashemipour M, Amini M, et al. [Tc]-99m thyroid scintigraphy in congenital hypothyroidism screening program. J Trop Pediatr. 2006; 52(6): 411–415.
  12. el-Desouki M, al-Jurayyan N, al-Nuaim A, et al. Thyroid scintigraphy and perchlorate discharge test in the diagnosis of congenital hypothyroidism. Eur J Nucl Med. 1995; 22(9): 1005–1008.
  13. Léger J, Olivieri A, Donaldson M, et al. ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE, Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab. 2014; 99(2): 363–384.
  14. Maciel LM, Kimura ET, Nogueira CR. Congenital hypothyroidism: recommendations of the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism. Arq Bras Endocrinol Metabol. 2013; 57(3): 184–192.
  15. Veisani Y, Sayehmiri K, Rezaeian S, et al. Congenital hypothyroidism screening program in iran; a systematic review and metaanalysis. Iran J Pediatr. 2014; 24(6): 665–672.
  16. Ghasemi M, Hashemipour M, Hovsepian S, et al. Prevalence of transient congenital hypothyroidism in central part of Iran. J Res Med Sci. 2013; 18(8): 699–703.
  17. Hashemipour M, Amini M, Talaie M, et al. Parental consanguinity among parents of neonates with congenital hypothyroidism in Isfahan. East Mediterr Health J. 2007; 13(3): 567–574.
  18. Albert BB, Cutfield WS, Webster D, et al. Etiology of increasing incidence of congenital hypothyroidism in New Zealand from 1993–2010. J Clin Endocrinol Metab. 2012; 97(9): 3155–3160.
  19. Eugène D, Djemli A, Van Vliet G. Sexual dimorphism of thyroid function in newborns with congenital hypothyroidism. J Clin Endocrinol Metab. 2005; 90(5): 2696–2700.
  20. Turan S, Bereket A, Angaji M, et al. The effect of the mode of delivery on neonatal thyroid function. J Matern Fetal Neonatal Med. 2007; 20(6): 473–476.
  21. McElduff A, McElduff P, Wiley V, et al. Neonatal thyrotropin as measured in a congenital hypothyroidism screening program: influence of the mode of delivery. J Clin Endocrinol Metab. 2005; 90(12): 6361–6363.
  22. Razavi Z, Mohammadi L. Permanent and Transient Congenital Hypothyroidism in Hamadan West Province of Iran. Int J Endocrinol Metab. 2016; 14(4): e38256.
  23. Rosenthal M, Addison GM, Price DA. Congenital hypothyroidism: increased incidence in Asian families. Arch Dis Child. 1988; 63(7): 790–793.
  24. Hashemipour M, Amini M, Kelishadi R, et al. Seasonal variation in the incidence of congenital hypothyroidism in Isfahan, Iran. Saudi Med J. 2007; 28(10): 1582–1586.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl