Objective: To study the growth, puberty and compliance of 66 hypothyroid children and to determine prognostic factors for adult height. Patients: 66 children were included (12 boys, 54 girls). Aetiologies were 43 ectopic glands, 14 thyroid agenesis, 9 dyshormonogenesis. Results: In girls the mean adult height was 164.7 ± 6.5 cm for a target height (TH) of 162.8 ± 5.4 cm. In boys the mean adult height was 178.2 ± 6.4 cm for a TH of 175.7 ± 4.7 cm. Puberty development was normal. Children who exceeded their TH had an earlier start of treatment versus children who failed to reach their TH: 24.8 ± 13.5 vs. 42.0 ± 47.3 days, p = 0.004. Delayed normalisation of TSH is a risk factor for bad compliance. Adequate correlations between treatment variables appeared only in children who exceeded their TH. Conclusions: TH, day of start of treatment and compliance with treatment are the main prognostic factors for adult height. Early detection of bad compliance is possible.

Keywords:
Congenital hypothyroidism, screening, Adult height, Puberty, Treatment, Compliance
1.
Dickerman Z, de Vries L: Prepubertal and pubertal growth, timing and duration of puberty and attained adult height in patients with congenital hypothyroidism detected by the neonatal screening programme for CH – A longitudinal study. Clin Endocrinol 1997;47:649–654.
2.
Tsoka E, Karavanaki K, Mengreli C, Yiannakou L, Pantelakis S: Growth and puberty in early treated congenital hypothyroidism (abstract). Horm Res 1997;48(suppl 2):161.
3.
Salerno M, Micillo M, Di Maio S, Capalbo D, Ferri P, Lettiero T, Tenore A: Longitudinal growth, sexual maturation and final height in patients with congenital hypothyroidism detected by neonatal screening. Eur J Endocrinol 2001;145:377–383.
4.
Siragusa V, Terenghi A, Rondanini GF, Vigone MC, Galli L, Weber G, Chiumello G: Evolution of height and bone age in primary congenital hypothyroidism. J Endocrinol Invest 1996;19:224–229.
5.
Thompson GN, McCrossin RB, Penfold JL, Woodroffe P, Rose WA, Robertson EF: Management and outcome of children with congenital hypothyroidism detected on neonatal screening in South Australia. Med J Aust 1986;145:18–22.
6.
Schultz RM, Glassman MS, MacGillivray MH: Elevated threshold for thyrotropin suppression in congenital hypothyroidism. Am J Dis Child 1980;134:19–20.
7.
Eldar D, Kaiserman I, Sack J: Early identification of congenital hypothyroid infants with abnormalities in pituitary setpoint for T4-induced TSH release. Horm Res 1993;40:194–200.
8.
McCrossin RB, Sheffield LJ, Robertson EF: Persisting abnormality in the pituitary-thyroid axis in congenital hypothyroidism; in Stockigt JR, Nagatakai S (eds): Thyroid Research. VIII. Canberra, Australian Academy of Sciences, 1980, pp 37–40.
9.
Cavaliere H, Medeiros-Neto GA, Rosner W, Kourides IA: Persistent pituitary resistance to thyroid hormone in congenital versus later-onset hypothyroidism. J Endocrinol Invest 1985;8:527–532.
10.
Hulse JA, Grant DB, Jackson D, Clayton BE: Growth, development and reassessment of hypothyroid infants diagnosed by screening. BMJ 1982;284:1435–1437.
11.
Grant DB, Fuggle PW, Smith I: Increased plasma thyroid stimulating hormone in treated congenital hypothyroidism: Relation to severity of hypothyroidism, plasma thyroid hormone status and daily dose of thyroxin. Arch Dis Child 1993;69:555–558.
12.
Pantsioutou S, Stanhope R, Uruena M, et al: Growth prognosis and growth after menarche in primary hypothyroidism. Arch Dis Child 1991;66:838–840.
13.
Abusrewil SSA, Tyfiels L, Savage DCL: Serum thyroxine and thyroid-stimulating hormone concentrations after treatment of congenital hypothyroidism. Arch Dis Child 1988;63:1368–1371.
14.
Heyerdahl S, Fase BF: The significance of elevated thyrotropin during treatment of congenital hypothyroidism. Acta Paediatr 1995;84:634–638.
15.
Grant DB: Congenital hypothyroidism: Optimal management in the light of 15 years’ experience of screening. Arch Dis Child 1995;72:85–89.
16.
Sato T, Suzuki Y, Taketani T, Ishiguro K, Nakajima H: Age related change in pituitary threshold for TSH release during thyroxine replacement therapy for cretinism. J Clin Endocrinol Metab 1977;44:553–559.
17.
Casado de Frìas E, Ruibal JL, Reverte F, Bueno G: Evolution of height and bone age in primary congenital hypothyroidism. Clin Pediatr 1993;32:426–432.
18.
Rivkees SA, Bode HH, Crawford JD: Long-term growth in juvenile acquired hypothyroidism: The failure to achieve normal adult stature. N Engl J Med 1988;318:599–602.
19.
Aronson R, Ehrlich RM, Bailey JD, Rovet JF: Growth in children with congenital hypothyroidism detected by neonatal screening. J Pediatr 1990;116:33–37.
20.
Fisher DA: Medical management of suspected cases of congenital hypothyroidism; in Burrow GN, Dussault JH (eds): Neonatal Thyroid Screening. New York, pp 237–245.
21.
New England Congenital Hypothyroidism Collaborative: Elementary school performance of children with congenital hypothyroidism. J Pediatr 1990;116:27–32.
22.
Illicki A, Larsson A: Psychological development at 7 years of age in children with congenital hypothyroidism. Timing and dosage of initial treatment. Acta Paediatr Scand 1991;80:199–204.
23.
Touati G, Leger J, Toublanc JE, Farraux Jp, Stuckens C, Ponte C, David M, Rochiccioli P, Porquet D, Czernichow P: A thyroxine dosage of 8 micrograms/kg per day is appropriate for the initial treatment of the majority of infants with congenital hypothyroidism. Eur J Pediatr 1997;156:94–98.
24.
Arrêtés du 24 janvier 1997 modifiant la liste des spécialités pharmaceutiques remboursables aux assurés sociaux. J Off Républ Fr, Jan 29, 1997, No 24, pp 1484–1501.
25.
Graffar M: Une méthode de classification sociale d’échantillons de populations. Courrier 1956;6:455–459.
26.
Pierson M, Deschamps JP, Leheup B: Les variations dites séculaires de la croissance et de la puberté. Arch Fr 1987;44:327–330.
27.
Frost GJ, Parkin JM: Management of patients with congenital hypothyroidism. Br Med J (Clin Res Ed) 1985;290:1485–1489.
28.
Boersma B, Otten BJ, Stoelinga GBA, Wit JM: Catch up growth after prolonged hypothyroidism. Eur J Pediatr 1996;155:362–367.
29.
Tillotson SL, Fuggle PW, Smith I, Ades AE, Grant DB: Relation between biochemical severity and intelligence in early treated congenital hypothyroidism: A threshold effect. BMJ 1994;309:440–445.
30.
Heyerdahl S, Kase BF, Stake G: Skeletal maturation during thyroxine treatment in children with congenital hypothyroidism. Acta Paediatr 1994;83:618–622.
31.
Working Group on Neonatal Screening of the European Society for Paediatric Endocrinology: Revised guidelines for neonatal screening programmes for primary congenital hypothyroidism. Horm Res 1999;52:49–52.
32.
Nelson JC, Clark SJ, Borut DL, Tomei RT, Carlton EI: Age-related changes in serum free thyroxine during childhood and adolescence. J Pediatr 1993;123:899–905.
33.
New England Congenital Hypothyroidism Collaborative: Correlation of cognitive test scores and adequacy of treatment in adolescents with congenital hypothyroidism. J Pediatr 1994;124:383–387.
34.
Wright EC: A lesson in non compliance. Lancet 1994;343:1305.
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2002
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