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

Maurizio Delvecchio, Mariacarolina Salerno, Maria Cristina Vigone, Malgorzata Wasniewska, Pietro Pio Popolo, Rosa Lapolla, Alessandro Mussa, Giulia Maria Tronconi, Ida D’Acunzo, Raffaella Di Mase, Rosa Maria Falcone, Andrea Corrias, Filippo De Luca, Giovanna Weber, Luciano Cavallo, Maria Felicia Faienza

Research output: Contribution to journalArticlepeer-review

Abstract

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/m2/day) of levothyroxine, respectively.

Original languageEnglish
Pages (from-to)674-680
Number of pages7
JournalEndocrine
Volume50
Issue number3
DOIs
Publication statusPublished - Dec 1 2015

Keywords

  • Congenital hypothyroidism
  • Congenital hypothyroidism etiology
  • Congenital hypothyroidism severity
  • Replacement therapy
  • Thyroxine requirement

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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