ESPE Abstracts (2022) 95 P1-390

ESPE2022 Poster Category 1 Thyroid (44 abstracts)

Does serum thyroglobulin predict thyroxine requirement during infancy in athyreosis and thyroid ectopia?

Wafa Kallali 1 , David Neumann 2 , Jeremy Jones 3 , Ian Hunter 4 , Anthony Tasker 5 , Karen Smith 6 , Guftar Shaikh 7 & Malcolm Donaldson 8

1Department of Paediatrics, Montpellier University Hospital, Montpellier, France; 2Department of Pediatrics, Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic; 3Kocaeli University, Faculty of Health Sciences, Kocaeli, Turkey; 4Department of Paediatrics, University Hospital Wishaw, Lanarkshire, United Kingdom; 5Department of Paediatrics, Victoria Hospital, Kirkcaldy, United Kingdom; 6Department of Biochemistry, Glasgow Royal Infirmary, Glasgow, United Kingdom; 7Department of Paediatric Endocrinology, Royal Hospital for Children, Glasgow, United Kingdom; 8Section of Child Health, Glasgow University School of Medicine, c/o Royal Hospital for Children, Glasgow, United Kingdom

Background: Thyroglobulin (Tg), a protein synthesized uniquely in the thyroid gland, may be elevated in primary congenital hypothyroidism (CH) due to increased TSH drive, absent in true athyreosis and Tg deficiency, and very elevated in some types of dyshormonogenesis.

Hypothesis: Serum Tg at the time of newborn screening may reflect the amount of thyroid tissue present in apparent athyreosis and thyroid ectopia, and hence provide a guide as to future levothyroxine (L-T4) requirement. This could be useful in avoiding overtreatment with L-T4.

Design: We studied the relationship between serum Tg at the time of referral in infants with CH due to athyreosis and ectopia, together with L-T4 dose (mg/m2), plasma TSH and free T4 (fT4) at diagnosis, 6 and 12 months.

Results: Median (range) Tg at diagnosis in 26 infants with true (n=9) and apparent (n=17) athyreosis, and ectopia (n=56) was 10 (1.9-58) and 177 (84.7-3977) µg/l respectively (reference range 91.3-148 in 3-day infants). In patients with ectopia, median (range) L-T4 dose (mg/m2) at 6 and 12 months was 102.4 (95.9-121.6) and 98 (83.9-114) respectively. There was a low negative correlation between serum Tg at diagnosis and L-T4 dose at 12 months (rho= -0.407, P=0.02), but no significant correlation at 6 months. In patients with athyreosis, median (range) L-T4 dose (mg/m2) at 6 and 12 months was 97.9 (89.2-103.9) and 109.1 (98-117.6) respectively, with no correlation between serum thyroglobulin and LT4 dose at 6 and 12 months.

Conclusion: As well as being of diagnostic value in some forms of CH, serum Tg at birth may be of value in guiding LT4 dosage during the first year of life especially in patients with thyroid ectopia. However, larger patient numbers and prospective study are needed to offset confounding variables including L-T4 dosing protocols and adherence.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.