In the last decade a high frequency of extrathyroidal congenital anomalies has been reported in infants with congenital hypothyroidism (CH) detected by neonatal screening. In the present study the occurrence of additional congenital malformations (CM) in a cohort of children with confirmed primary CH due to thyroid dysgenesis was investigated. A high prevalence of extrathyroidal major congenital anomalies (15.9%), more than 5-fold higher than that reported in the Egyptian population (2.7%), was found. The cardiac and musculoskeletal systems were the most commonly involved, comprising 9.09 and 47.72% of all anomalies, respectively. The high prevalence of musculoskeletal anomalies in this study was mostly due to minor anomalies as brachydactyly and digitalization of thumbs. The type of dysgenesis (i.e. aplastic, ectopic or hypoplastic) as well as the severity of hypothyroidism, as assessed by TSH and T4 levels at diagnosis, had no relation with the occurrence of extrathyroidal abnormalities.

1.
Olivieri A, Stazi MA, Mastroiacovo P, Fazzini C, Medda E, Spagnolo A, De Angelis S, Grandolfo ME, Taruscio D, Cordeddu V, Sorcini M, and The Study Group For Congenital Hypothyroidism: A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian registry for congenital hypothyroidism (1991–1998). J Clin Endocrinol Metab 2002;87:557–562.
2.
Gougard J, Safar A, Rolland A, Job JC: Epidémiologie des hypothyroïdies congénitales malformatives. Arch Fr Pédiatr 1981;38:875–879.
3.
Lorey FW, Cunningham GC: Birth prevalence of primary congenital hypothyroidism by sex and ethnicity. Hum Biol 1992;64:531–538.
4.
Grant DB, Smith I: Survey of neonatal screening for primary hypothyroidism in England, Wales, and Northern Ireland 1982–1982–4. Br Med J (Clin Res Ed) 1988;296:1355–1358.
5.
Knobel M, Medeiros-Neto G: An outline of inherited disorders of the thyroid hormone-generating system. Thyroid 2003;13:771–801.
6.
Devos H, Rodd C, Gagne N, Laframboise R, Van Vliet G: A search for the possible molecular mechanisms of thyroid dysgenesis: sex ratios and associated malformations. J Clin Endocrinol Metab 1999;84:2502–2506.
7.
Lazarus JH, Hugues IA: Congenital abnormalities and congenital hypothyroidism. Lancet 1988;2:52.
8.
Siebner R, Merlob P, Kaiserman I, Sack J: Congenital anomalies concomitant with persistent primary congenital hypothyroidism. Am J Med Genet 1992;44:57–60.
9.
Stoll C, Dott B, Alembik Y, Koehl C: Congenital anomalies associated with congenital hypothyroidism. Ann Genet 1999;42:17–20.
10.
Roberts HE, Moore CA, Fernhoff PM, Brown AL, Khoury MJ: Population study of congenital hypothyroidism and associated birth defects, Atlanta, 1979–1992. Am J Med Genet 1997;71:29–32.
11.
Castanet M, Polak M, Bonaïti-Pellié C, Lyonnet S, Czernichow P, Léger J: Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. J Clin Endocrinol Metab 2001;86:2009–2014.
12.
El Kholy M, El Sayed S, Shehata K, Radwan H, Erfan M, El Naggar M: High prevalence of thyroid developmental anomalies in the first-degree relatives of children with thyroid dysgenesis. Horm Res 2005;64(suppl 1):116.
13.
Léger J, Marinovic D, Garel C, Catherine Bonaïti-Pellié C, Polak M, Czernichow P: Thyroid developmental anomalies in first-degree relatives of children with congenital hypothyroidism J Clin Endocrinol Metab 2002;87:575–580.
14.
Ueda D: Normal volume of thyroid gland in children. J Clin Ultrasound 1990;18:455–462.
15.
Feingold M, Bossert WH: Birth Defects 1974;10:suppl 13.
16.
Daniel WW: Biostatistics: A Foundation for Analysis in the Health Sciences, ed 6. New York, Wiley, 1995.
17.
Trueba SS, Augé J, Mattei G, Etchevers H, Martinovic J, Czernichow P, Vekemans M, Polak M, Attié-Bitach T: PAX8, TITF1, and FOXE1 gene expression patterns during human development: new insights into human thyroid development and thyroid dysgenesis-associated malformations J Clin Endocrinol Metab 2005;90:455–462.
18.
Dentice M, Cordeddu V, Rosica A, Ferrara AM, Santarpia L, Salvatore D, Chiovato L, Perri A, Moschini L, Fazzini C, Olivieri A, Costa P, Stoppioni V, Baserga M, De Felice M, Sorcini M, Fenzi G, Di Lauro R, Tartaglia M, Macchia PE: Missense mutation in the transcription factor NKX2–5: a novel molecular event in the pathogenesis of thyroid dysgenesis. J Clin Endocrinol Metab2006;91:1428–1433.
19.
Shawky RM, Elsedfy H, Abo Louz SK, Labatia GY: Prevalence of congenital malformations in a thousand consecutive Egyptian live born. Egypt J Med Hum Genet 2001;2:43–53.
20.
Oakley GA, Muir T, Ray M, Girdwood RW, Kennedy R, Donaldson MD: Increased incidence of congenital malformations in children with transient thyroid-stimulating hormone elevation on neonatal screening. J Pediatr 1998;132:726–730.
21.
Kreisner E, Neto EC, Gross JL: High prevalence of extrathyroid malformations in a cohort of Brazilian patients with permanent primary congenital hypothyroidism. Thyroid 2005;15:165–169.
22.
Chao T, Wang JR, Hwang B: Congenital hypothyroidism and concomitant anomalies. J Pediatr Endocrinol Metab 1997;10:217–221.
23.
Milenkovic T, Zdravkovic D, Rajic V, Banicevic M: Extrathyroidal congenital abnormalities in children with congenital hypothyroidism. 41st Annual Meeting of the European Society for Paediatric Endocrinology, Madrid, September 25–28, 2002, P2–P424.
24.
Chan KM: Congenital upper limb anomalies – the principle of management. J Hong Kong Physiother Assoc 1984;6:1–4.
25.
Balestrazzi P, Sorcini M, Grandolfo ME, Lorenzetti ME, Giovannelli G: The association between hypothyroidism and other congenital defects. The experience of the National Registry in 1987–1992. Ann Ist Super Sanita 1994;30:289–293.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.