Methods: We performed retrospective study using database of the patients with congenital hypothyroidism treated with or without Levo-Thyroxine at Bundang Jesaeng General Hospital, from January 1998 to February 2016. Their ages, birth weights, gestational ages, symptoms, ages at diagnosis and treatment were recorded. We measured TSH, free thyroxine (FT4), triiodothyronine (TT3) levels at diagnosis and treatment, and those levels at one, two and three months after treatment. Thyroid scan (Tc99m scintigraphy) and thyroid ultrasonography reports were described.
Results: Among the 282 neonates included in this analysis, 51 were diagnosed with congenital hypothyroidism. The sex distribution was male 51% (26/51) vs. female 49% (25/51). Their initial postnatal ages of starting Levo-thyroxine treatment were 26.97±15.4 days. 27 patients out of 51 were identified as TCH and 24 were revealed Permanent Congenital Hypothyroidism (PCH). In the TCH patients group, male patients were 66.7% (18/27) and female patients were 33.3% (9/27). Ages of initial treatment of TCH were 31.15±13.78 days. The sex distribution of PCH was male 33.3% (8/24) vs. female 66.7% (16/24). Ages of initial treatment of PCH patients were 27.93±31.07 days. The mean duration of treatment in TCH group were 28.94±13.89 months. Serum TSH levels were measured at diagnosis of PCH group (mean 150.49, median 77.70, 2575% 43.8185 μIU/ml) were significantly higher than those of TCH group (mean 30.29, median 21.40, 2575% 17.1291 μIU/ml) (P<0.001). FT4 levels (PCH; 0.73±0.50 ng/dl vs TCH; 1.17±0.53 ng/dl, P<0.02) and TT3 levels (PCH; 1.36±0.68 ng/ml, vs TCH; 1.90±0.35 ng/ml, P<0.019) measured at start of treatment also showed significant differences. FT4 level measured at two months later from start of treatment in PCH group were significantly higher than TCH group (P<0.034). Required treatment doses were significantly different only that of 2-years of therapy. Thyroid USG were normal in 53.3% of patients with PCH. Comparably, those of all patients of TCH group were normal. We found another difference in Tc99m scintigraphy reports of both group. The sizes of thyroids in patients of PCH group were bigger than TCH group (P<0.033).
Conclusion: According to these data, we might consider initial measurements of serum TSH, FT4, T3 and size of thyroid as predictive factors in categorizing TCH from PCH.
10 Sep 2016 - 12 Sep 2016