Levothyroxine requirement in congenital hypothyroidism: a 12-year longitudinal study.

Autor: Delvecchio M; Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy. mdelvecchio75@gmail.com., Salerno M; Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy., Vigone MC; Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy., Wasniewska M; Department of Pediatrics, University of Messina, Messina, Italy., Popolo PP; Department of Pediatrics, University of Foggia, Foggia, Italy., Lapolla R; Department of Pediatrics, University of Foggia, Foggia, Italy., Mussa A; Division of Pediatric Endocrinology, Department of Pediatrics, University of Turin, Turin, Italy., Tronconi GM; Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy., D'Acunzo I; Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy., Di Mase R; Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy., Falcone RM; Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy., Corrias A; Division of Pediatric Endocrinology, Department of Pediatrics, University of Turin, Turin, Italy., De Luca F; Department of Pediatrics, University of Messina, Messina, Italy., Weber G; Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy., Cavallo L; Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy., Faienza MF; Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2015 Dec; Vol. 50 (3), pp. 674-80. Date of Electronic Publication: 2015 Mar 12.
DOI: 10.1007/s12020-015-0574-1
Abstrakt: The aim of the replacement therapy with levothyroxine in congenital hypothyroidism (CH) is to correct hypothyroidism and ensure normal growth and neuropsychological development. Few data are available about the appropriate dose during childhood and early adolescence; therefore, we performed a multicenter observational study in a large population of patients with CH to assess the required levothyroxine dose to obtain euthyroidism. We recruited 216 patients with permanent CH classified into three groups (agenesia, ectopia, and in situ gland) on the basis of the thyroid imaging. The levothyroxine dose was recorded at 6 and 12 months and then yearly until 12 years of age. The daily levothyroxine requirement progressively decreased during the follow-up, irrespective of etiology. It was significantly lower in patients with in situ gland than in patients with athyreosis during the entire study period and with ectopic gland from the age of 1 year. The levothyroxine requirement at 6 months of age was correlated with the requirement at each later time-point. The daily dose was modified less frequently in patients with in situ thyroid (36 %) than in patients with ectopic gland (41.4 %) or with athyreosis (43.6 %). Patients with in situ gland required a lower dose than the other two subgroups. The dose at 6 months seems predictive of the requirement until 12 years of age. Euthyroidism may be achieved in pre-school and in-school patients by 3-4 and 2-3 µg/kg/day (70-90 and 60-80 µg/m(2)/day) of levothyroxine, respectively.
Databáze: MEDLINE
Externí odkaz: