RESUMO
A woman receiving thyroxine substitution therapy for acquired hypothyroidism caused by autoimmune thyroiditis gave birth to three babies who had transient primary hypothyroidism. All three babies had elevated thyrotropin levels on neonatal screening, but one had normal thyroxine values. Thyrotropin receptor-blocking antibodies were present in maternal serum and in the three neonates. Each baby also had a different congenital malformation. The neurodevelopmental outcome of the children appeared related in part to maternal thyroxine levels, which suggests that transplacental transfer of thyroxine may protect the fetal brain.
Assuntos
Hipotireoidismo Congênito , Complicações na Gravidez/tratamento farmacológico , Tireoidite Autoimune/tratamento farmacológico , Tiroxina/sangue , Tiroxina/uso terapêutico , Adulto , Pré-Escolar , Feminino , Seguimentos , Cardiopatias Congênitas/epidemiologia , Hérnia Umbilical/epidemiologia , Humanos , Hipotireoidismo/epidemiologia , Recém-Nascido , Rim/anormalidades , Masculino , Gravidez , Complicações na Gravidez/sangue , Tireoidite Autoimune/sangue , Tireoidite Autoimune/complicações , Tireotropina/sangue , Fatores de TempoRESUMO
Twenty-seven patients with congenital hypothyroidism diagnosed by neonatal screening were examined at the age of 12 years. The 12 patients with severe hypothyroidism at diagnosis (thyroxine < 2 micrograms/dl (< 26 nmol/L), and area-of-the-knee epiphyses < 0.05 cm2 had a lower IQ than the 15 patients with less severe hypothyroidism (mean +/- SD, 89 +/- 17 vs 104 +/- 10; p < 0.007). Comparisons of patients and siblings confirm that this difference was due to the severity of hypothyroidism.
Assuntos
Hipotireoidismo Congênito , Inteligência , Criança , Feminino , Seguimentos , Humanos , Hipotireoidismo/diagnóstico , Recém-Nascido , Masculino , Triagem NeonatalRESUMO
A prospective study of the mental development of hypothyroid infants detected by the Quebec Network for Genetic Medicine began in January, 1976. The mean age at initiation of thyroid hormone therapy was 27 days. Forty-five hypothyroid infants and 37 normal control subjects were assessed at age 12 months with the Griffiths mental development test; 77 and 41, respectively, were assessed at age 18 months, and 59 and 40, respectively, at 36 months. There were no statistically significant differences in the various test scores between the two populations at age 12 months, but at age 18 and 36 months the hypothyroid infants had lower scores in hearing-speech performance scales and practical reasoning (36 months) which also decreased their global quotient. The mean scores were still above 100 and only nine were below 85. Further assessment of the influence of early therapy on mental development at age 6 years is needed before definitive statements can be made about the long-term mental development in these subjects.