Long-term effects of L-T4 treatment on physical and intellectual development for congenital hypothyroidism

Abstract

To explore the long-term effects of L-T4 treatment on physical and intellectual development in neonatal congenital hypothyroidism(CH) patients during adolescence and adulthood. 14 out of 15 patients, aged 15-31 years old, including 9 males and 6 females, were diagnosed by neonatal screening for congenital hypothyroidism. (1)By treatment for 10 years until adolescence, return visit ages were 12.6-18.1 years old, the height of patients were normal in 14 cases, weight normal in 8 cases, and overweight in 6 cases. Only the first patient of neonatal screening for congenital hypothyroidism height 154 cm, weight of 43.5 kg, which were below the standard. Bone age by X-ray showed 9 normal, 1 case of rapid development, 4 cases with left wrist bone age retardation. IQ combined Raven's test(CRT) showed 3 cases excellent, 7 cases normal, 3 cases borderline, and 2 cases low. (2)Treatment for more than 20 years to adulthood, 9 cases of return visits (8 cases were screened out) by 23-31 years of age, with 5 males and 4 females, height and bone age were all normal, normal weight, only 2 cases BMI slightly overweight. As to IQ, good were in 7 cases, mild retardation in 2 cases. 7 patients received above average education; they were all employed except one. The employed patients were all capable for their jobs. In summary, screening out of 8 patients, 1 case were of mild mental retardation (12.5%); while 7 patients(87.5%), both in physical and intellectual levels were as those of the normal population. (Chin J Endocrinol Metab, 2015, 31: 887-890) Key words: Hypothyroidism; Long-term effects; Neonatal screening; Adolescence; Adulthood