Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review

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To Cite : Rahmani K, Yarahmadi S, Etemad K, Koosha A, Mehrabi Y, et al. Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review, Int J Endocrinol Metab. 2016 ;14(3):e36080. doi: 10.5812/ijem.36080.
Copyright: Copyright © 2016, International Journal of Endocrinology and Metabolism. .
1. Context
2. Evidence Acquisition
3. Results
4. Conclusions
  • 1. Gruters A, Krude H. Detection and treatment of congenital hypothyroidism. Nat Rev Endocrinol. 2012; 8(2): 104-13[DOI][PubMed]
  • 2. Tylek-Lemanska D, Ratajczak R, Szczepaniak B, Dziatkowiak H, Rybakowa M. Mass screening program for congenital hypothyroidism in south-eastern Poland. J Pediatr Endocrinol Metab. 1999; 12(5): 653-7[PubMed]
  • 3. Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams textbook of endocrinology. 2015;
  • 4. Biondi B, Wartofsky L. Treatment with thyroid hormone. Endocr Rev. 2014; 35(3): 433-512[DOI][PubMed]
  • 5. Velkeniers B, Van Meerhaeghe A, Poppe K, Unuane D, Tournaye H, Haentjens P. Levothyroxine treatment and pregnancy outcome in women with subclinical hypothyroidism undergoing assisted reproduction technologies: systematic review and meta-analysis of RCTs. Hum Reprod Update. 2013; 19(3): 251-8[DOI][PubMed]
  • 6. Aronson R, Ehrlich RM, Bailey JD, Rovet JF. Growth in children with congenital hypothyroidism detected by neonatal screening. J Pediatr. 1990; 116(1): 33-7[PubMed]
  • 7. Rovet J, Ehrlich R, Sorbara D. Intellectual outcome in children with fetal hypothyroidism. J Pediatr. 1987; 110(5): 700-4[PubMed]
  • 8. Gilbert ME, Rovet J, Chen Z, Koibuchi N. Developmental thyroid hormone disruption: prevalence, environmental contaminants and neurodevelopmental consequences. Neurotoxicology. 2012; 33(4): 842-52[DOI][PubMed]
  • 9. Zimmermann MB. The role of iodine in human growth and development. Semin Cell Dev Biol. 2011; 22(6): 645-52[DOI][PubMed]
  • 10. Ehrlich RM. Thyroxine dose for congenital hypothyroidism. Clin Pediatr (Phila). 1995; 34(10): 521-2[PubMed]
  • 11. Rovet J. Congenital hypothyroidism: treatment and outcome. Curr Opin Endocrinol. 2005; 12(1): 42-52
  • 12. Alvarez M, Iglesias Fernandez C, Rodriguez Sanchez A, Dulin Lniguez E, Rodriguez Arnao MD. Episodes of overtreatment during the first six months in children with congenital hypothyroidism and their relationships with sustained attention and inhibitory control at school age. Horm Res Paediatr. 2010; 74(2): 114-20[DOI][PubMed]
  • 13. Rovet JF, Ehrlich R. Psychoeducational outcome in children with early-treated congenital hypothyroidism. Pediatrics. 2000; 105(3 Pt 1): 515-22[PubMed]
  • 14. Clause M. Newborn screening for congenital hypothyroidism. J Pediatr Nurs. 2013; 28(6): 603-8[DOI][PubMed]
  • 15. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med. 2007; 45(4): 247-51[DOI][PubMed]
  • 16. Roos A, Linn-Rasker SP, van Domburg RT, Tijssen JP, Berghout A. The starting dose of levothyroxine in primary hypothyroidism treatment: a prospective, randomized, double-blind trial. Arch Intern Med. 2005; 165(15): 1714-20[DOI][PubMed]
  • 17. Selva KA, Mandel SH, Rien L, Sesser D, Miyahira R, Skeels M, et al. Initial treatment dose of L-thyroxine in congenital hypothyroidism. J Pediatr. 2002; 141(6): 786-92[DOI][PubMed]
  • 18. Boileau P, Bain P, Rives S, Toublanc JE. Earlier onset of treatment or increment in LT4 dose in screened congenital hypothyroidism: which as the more important factor for IQ at 7 years? Horm Res. 2004; 61(5): 228-33[PubMed]
  • 19. Dimitropoulos A, Molinari L, Etter K, Torresani T, Lang-Muritano M, Jenni OG, et al. Children with congenital hypothyroidism: long-term intellectual outcome after early high-dose treatment. Pediatr Res. 2009; 65(2): 242-8[DOI][PubMed]
  • 20. Yang RL, Zhu ZW, Zhou XL, Zhao ZY. Treatment and follow-up of children with transient congenital hypothyroidism. J Zhejiang Univ Sci B. 2005; 6(12): 1206-9[DOI][PubMed]
  • 21. Touati G, Leger J, Toublanc JE, Farriaux JP, Stuckens C, Ponte C, et al. A thyroxine dosage of 8 micrograms/kg per day is appropriate for the initial treatment of the majority of infants with congenital hypothyroidism. Eur J Pediatr. 1997; 156(2): 94-8[PubMed]
  • 22. Kempers MJ, van der Sluijs Veer L, Nijhuis-van der Sanden RW, Lanting CI, Kooistra L, Wiedijk BM, et al. Neonatal screening for congenital hypothyroidism in the Netherlands: cognitive and motor outcome at 10 years of age. J Clin Endocrinol Metab. 2007; 92(3): 919-24[DOI][PubMed]
  • 23. Oerbeck B, Sundet K, Kase BF, Heyerdahl S. Congenital hypothyroidism: no adverse effects of high dose thyroxine treatment on adult memory, attention, and behaviour. Arch Dis Child. 2005; 90(2): 132-7[DOI][PubMed]
  • 24. Rovet JF, Ehrlich RM. Long-term effects of L-thyroxine therapy for congenital hypothyroidism. J Pediatr. 1995; 126(3): 380-6[PubMed]
  • 25. Kempers MJ, van der Sluijs Veer L, Nijhuis-van der Sanden MW, Kooistra L, Wiedijk BM, Faber I, et al. Intellectual and motor development of young adults with congenital hypothyroidism diagnosed by neonatal screening. J Clin Endocrinol Metab. 2006; 91(2): 418-24[DOI][PubMed]
  • 26. Revised guidelines for neonatal screening programmes for primary congenital hypothyroidism. Working Group on Neonatal Screening of the European Society for Paediatric Endocrinology. Horm Res. 1999; 52(1): 49-52[PubMed]
  • 27. American Academy of P, Rose SR, Section on E, Committee on Genetics ATA, Brown RS, Public Health Committee LWPES, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006; 117(6): 2290-303[DOI][PubMed]
  • 28. Jones JH, Gellen B, Paterson WF, Beaton S, Donaldson MD. Effect of high versus low initial doses of L-thyroxine for congenital hypothyroidism on thyroid function and somatic growth. Arch Dis Child. 2008; 93(11): 940-4[DOI][PubMed]
  • 29. Dickerman Z, De Vries L. Prepubertal and pubertal growth, timing and duration of puberty and attained adult height in patients with congenital hypothyroidism (CH) detected by the neonatal screening programme for CH--a longitudinal study. Clin Endocrinol (Oxf). 1997; 47(6): 649-54[PubMed]
  • 30. Bongers-Schokking JJ, Koot HM, Wiersma D, Verkerk PH, de Muinck Keizer-Schrama SM. Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism. J Pediatr. 2000; 136(3): 292-7[DOI][PubMed]
  • 31. Dubuis J, Glorieux J, Richer F, Deal CL, Dussault JH, Van Vliet G. Outcome of severe congenital hypothyroidism: closing the developmental gap with early high dose levothyroxine treatment. J Clin Endocrinol Metab. 1996; 81(1): 222-7
  • 32. Salerno M, Militerni R, Bravaccio C, Micillo M, Capalbo D, Di MS, et al. Effect of different starting doses of levothyroxine on growth and intellectual outcome at four years of age in congenital hypothyroidism. Thyroid. 2002; 12(1): 45-52[DOI][PubMed]
  • 33. Bongers-Schokking JJ, de Muinck Keizer-Schrama SM. Influence of timing and dose of thyroid hormone replacement on mental, psychomotor, and behavioral development in children with congenital hypothyroidism. J Pediatr. 2005; 147(6): 768-74[DOI][PubMed]
  • 34. Selva KA, Harper A, Downs A, Blasco PA, Lafranchi SH. Neurodevelopmental outcomes in congenital hypothyroidism: comparison of initial T4 dose and time to reach target T4 and TSH. J Pediatr. 2005; 147(6): 775-80[DOI][PubMed]
  • 35. Campos SP, Sandberg DE, Barrick C, Voorhess ML, MacGillivray MH. Outcome of lower L-thyroxine dose for treatment of congenital hypothyroidism. Clin Pediatr (Phila). 1995; 34(10): 514-20[PubMed]
  • 36. Hrytsiuk I, Gilbert R, Logan S, Pindoria S, Brook CG. Starting dose of levothyroxine for the treatment of congenital hypothyroidism: a systematic review. Arch Pediatr Adolesc Med. 2002; 156(5): 485-91[PubMed]
  • 37. Simoneau-Roy J, Marti S, Deal C, Huot C, Robaey P, Van Vliet G. Cognition and behavior at school entry in children with congenital hypothyroidism treated early with high-dose levothyroxine. J Pediatr. 2004; 144(6): 747-52[DOI][PubMed]
  • 38. Salerno M, Micillo M, Di Maio S, Capalbo D, Ferri P, Lettiero T, et al. Longitudinal growth, sexual maturation and final height in patients with congenital hypothyroidism detected by neonatal screening. Eur J Endocrinol. 2001; 145(4): 377-83[PubMed]
  • 39. Germak JA, Foley TJ. Longitudinal assessment of L-thyroxine therapy for congenital hypothyroidism. J Pediatr. 1990; 117(2 Pt 1): 211-9[PubMed]
  • 40. Ilicki A, Larsson A. Psychological development at 7 years of age in children with congenital hypothyroidism. Timing and dosage of initial treatment. Acta Paediatr Scand. 1991; 80(2): 199-204[PubMed]
  • 41. Kundu R, Chakrabartty S. Treating congenital hypothyroidism: maximum age limit up to which a socially compatible child is expected. J Indian Med Assoc. 1996; 94(3): 96-8[PubMed]
  • 42. Chiesa A, Gruneiro de Papendieck L, Keselman A, Heinrich JJ, Bergada C. Growth follow-up in 100 children with congenital hypothyroidism before and during treatment. J Pediatr Endocrinol. 1994; 7(3): 211-7[PubMed]
  • 43. Lu YH, Liu XY, Song Y. [Effects of early treatment on physical and intelligence development in children with congenital hypothyroidism]. Zhongguo Dang Dai Er Ke Za Zhi. 2012; 14(6): 418-21[PubMed]
  • 44. Glorieux J, Dussault JH, Letarte J, Guyda H, Morissette J. Preliminary results on the mental development of hypothyroid infants detected by the Quebec Screening Program. J Pediatr. 1983; 102(1): 19-22[PubMed]
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