Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study

Purpose To identify clinical predictors of permanent congenital hypothyroidism (PCH) and transient congenital hypothyroidism (TCH). Methods This retrospective cohort study enrolled neonates with risk factors for congenital hypothyroidism as diagnosed by neonatal screening test or blood testing. Levo...

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Main Authors: Niki Dermitzaki, Vasileios Giapros, Marianna Deligeorgopoulou, Vasiliki Rengina Tsinopoulou, Eleni Kotanidou, Maria Baltogianni, Foteini Balomenou, Anastasios Serbis
Format: Article
Language:English
Published: Korean Society of Pediatric Endocrinology 2025-06-01
Series:Annals of Pediatric Endocrinology & Metabolism
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Online Access:http://e-apem.org/upload/pdf/apem-2448126-063.pdf
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author Niki Dermitzaki
Vasileios Giapros
Marianna Deligeorgopoulou
Vasiliki Rengina Tsinopoulou
Eleni Kotanidou
Maria Baltogianni
Foteini Balomenou
Anastasios Serbis
author_facet Niki Dermitzaki
Vasileios Giapros
Marianna Deligeorgopoulou
Vasiliki Rengina Tsinopoulou
Eleni Kotanidou
Maria Baltogianni
Foteini Balomenou
Anastasios Serbis
author_sort Niki Dermitzaki
collection DOAJ
description Purpose To identify clinical predictors of permanent congenital hypothyroidism (PCH) and transient congenital hypothyroidism (TCH). Methods This retrospective cohort study enrolled neonates with risk factors for congenital hypothyroidism as diagnosed by neonatal screening test or blood testing. Levothyroxine (LT4) dose and serum thyroid stimulating hormone (TSH) concentrations were recorded from birth to 3 years of age. Results We enrolled 88 neonates, 35 with PCH and 53 with TCH. An LT4 dose > 3.8 μg/kg/day at 6 months (sensitivity 62%, specificity 96%), 3.0 μg/kg/day at 12 months (64%, 97%, respectively), 2.6 μg/kg/day at 2 years (80%, 98%), and 2.5 μg/kg/day at 3 years (89%, 98%) of age could predict PCH. Daily total LT4 doses > 50 µg at any time during the follow-up period were found solely in the PCH group (28% vs 0%, P<0.001). Independent discriminative predictors of PCH and TCH were TSH concentrations at diagnosis (beta=-4.3, P<0.001); daily LT4 dose at 6 (beta=-2.9, P=0.004), 12 (beta=-3.4, P=0.001), and 24 months of age (beta=-3.2, P=0.001); TSH > 5 μIU/mL at any time after treatment initiation (beta=-3.6, P<0.001); and increase in LT4 dose by more than twice (beta=-3.2, P<0.001). Conclusions Discrimination between PCH and TCH was achieved based on serum TSH concentrations at diagnosis, TSH > 5 μIU/mL during treatment, LT4 dose, LT4 > 50 µg during treatment, and increasing LT4 dose during treatment.
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institution Kabale University
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series Annals of Pediatric Endocrinology & Metabolism
spelling doaj-art-0582ca5bb7b0440a8ed1096f04a915762025-08-20T03:27:15ZengKorean Society of Pediatric EndocrinologyAnnals of Pediatric Endocrinology & Metabolism2287-10122287-12922025-06-0130314915610.6065/apem.2448126.0631086Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort studyNiki Dermitzaki0Vasileios Giapros1Marianna Deligeorgopoulou2Vasiliki Rengina Tsinopoulou3Eleni Kotanidou4Maria Baltogianni5Foteini Balomenou6Anastasios Serbis7 Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece Pediatric Department, School of Medicine, University of Ioannina, Ioannina, Greece 2nd Department of Pediatrics, AHEPA University General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece 2nd Department of Pediatrics, AHEPA University General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece Pediatric Department, School of Medicine, University of Ioannina, Ioannina, GreecePurpose To identify clinical predictors of permanent congenital hypothyroidism (PCH) and transient congenital hypothyroidism (TCH). Methods This retrospective cohort study enrolled neonates with risk factors for congenital hypothyroidism as diagnosed by neonatal screening test or blood testing. Levothyroxine (LT4) dose and serum thyroid stimulating hormone (TSH) concentrations were recorded from birth to 3 years of age. Results We enrolled 88 neonates, 35 with PCH and 53 with TCH. An LT4 dose > 3.8 μg/kg/day at 6 months (sensitivity 62%, specificity 96%), 3.0 μg/kg/day at 12 months (64%, 97%, respectively), 2.6 μg/kg/day at 2 years (80%, 98%), and 2.5 μg/kg/day at 3 years (89%, 98%) of age could predict PCH. Daily total LT4 doses > 50 µg at any time during the follow-up period were found solely in the PCH group (28% vs 0%, P<0.001). Independent discriminative predictors of PCH and TCH were TSH concentrations at diagnosis (beta=-4.3, P<0.001); daily LT4 dose at 6 (beta=-2.9, P=0.004), 12 (beta=-3.4, P=0.001), and 24 months of age (beta=-3.2, P=0.001); TSH > 5 μIU/mL at any time after treatment initiation (beta=-3.6, P<0.001); and increase in LT4 dose by more than twice (beta=-3.2, P<0.001). Conclusions Discrimination between PCH and TCH was achieved based on serum TSH concentrations at diagnosis, TSH > 5 μIU/mL during treatment, LT4 dose, LT4 > 50 µg during treatment, and increasing LT4 dose during treatment.http://e-apem.org/upload/pdf/apem-2448126-063.pdfcongenital hypothyroidismlevothyroxinepermanent congenital hypothyroidismtransient congenital hypothyroidism
spellingShingle Niki Dermitzaki
Vasileios Giapros
Marianna Deligeorgopoulou
Vasiliki Rengina Tsinopoulou
Eleni Kotanidou
Maria Baltogianni
Foteini Balomenou
Anastasios Serbis
Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
Annals of Pediatric Endocrinology & Metabolism
congenital hypothyroidism
levothyroxine
permanent congenital hypothyroidism
transient congenital hypothyroidism
title Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
title_full Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
title_fullStr Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
title_full_unstemmed Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
title_short Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study
title_sort predictive factors of permanent versus transient congenital hypothyroidism a pragmatic cohort study
topic congenital hypothyroidism
levothyroxine
permanent congenital hypothyroidism
transient congenital hypothyroidism
url http://e-apem.org/upload/pdf/apem-2448126-063.pdf
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