In:
Clinical Endocrinology, Wiley, Vol. 84, No. 3 ( 2016-03), p. 438-444
Abstract:
Mild or borderline congenital hypothyroidism [often referred to as mild neonatal hyperthyrotropinemia ( MNH )] is characterized by an abnormal newborn screen ( NBS ), followed by mildly elevated TSH and normal FT 4 on confirmatory testing. This condition is increasingly observed, but data regarding optimal management are limited. Objective Examine the use of routine technetium thyroid scanning ( TS ) in the management of MNH . Methods Retrospective study of infants with MNH between 2000 and 2011. We assessed the clinical course of infants with MNH according to TS results; as a comparator, infants with classic congenital hypothyroidism ( CH ) were analysed in parallel. Results We identified 69 infants (52% boys) with MNH and 164 (34% boys) with classic CH . TS results were divided into four subgroups: no uptake in 7% of MNH vs 24% of classic CH ( P 〈 0·01), decreased uptake/anatomical abnormalities in 39% vs 46% (p = NS ), increased uptake in 35% vs 26% (p = NS ) and normal uptake in 19% vs 4% ( P 〈 0·01). In MNH , neither NBS ‐ TSH , confirmatory TSH and FT 4, mean LT ‐4 treatment doses and number of dose escalations, nor post‐treatment FT 4 and TSH differed among the four subgroups. In contrast, clinical features in infants with classic CH differed among the subgroups. Among MNH infants who reached 3 years of age, trial‐off treatment was successful in 6 of 11 (55%) with no apparent difference in success rates among TS subgroups. Conclusions The information provided by TS during evaluation of MNH does not predict clinical course; obtaining these scans in infants with MNH may not be an effective use of healthcare resources.
Type of Medium:
Online Resource
ISSN:
0300-0664
,
1365-2265
DOI:
10.1111/cen.2016.84.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2004597-9
