Free Thyroid Hormones in Evaluating Persistently Elevated Thyrotropin Levels in Children with Congenital Hypothyroidism on Replacement Therapy

1984 ◽  
Vol 59 (6) ◽  
pp. 1211-1214 ◽  
Author(s):  
F. FOCARILE ◽  
G. F. RONDANINI ◽  
A. BOLLATI ◽  
A. BARTOLUCCI ◽  
G. CHIUMELLO
Keyword(s):  
Thyroid Hormones ◽  
Replacement Therapy ◽  
Congenital Hypothyroidism ◽  
Free Thyroid Hormones

scholarly journals The different requirement of l-T4 therapy in congenital athyreosis compared with adult-acquired hypothyroidism suggests a persisting thyroid hormone resistance at the hypothalamic–pituitary level

2014 ◽  
Vol 171 (5) ◽  
pp. 615-621 ◽  
Author(s):  
Brunella Bagattini ◽  
Caterina Di Cosmo ◽  
Lucia Montanelli ◽  
Paolo Piaggi ◽  
Mariella Ciampi ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Total Thyroidectomy ◽  
Replacement Therapy ◽  
Adult Patients ◽  
Hormone Deficiency ◽  
Fetal Life ◽  
Free Thyroid Hormones ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Design And Methods

BackgroundLevothyroxine (l-T4) is commonly employed to correct hormone deficiency in children with congenital hypothyroidism (CH) and in adult patients with iatrogenic hypothyroidism.ObjectiveTo compare the daily weight-based dosage of the replacement therapy withl-T4in athyreotic adult patients affected by CH and adult patients with thyroid nodular or cancer diseases treated by total thyroidectomy.Design and methodsA total of 36 adult patients (27 females and nine males) aged 18–29 years were studied; 13 patients (age: 21.5±2.1, group CH) had athyreotic CH treated withl-T4since the first days of life. The remaining 23 patients (age: 24±2.7, group AH) had hypothyroidism after total thyroidectomy (14 patients previously affected by nodular disease and nine by thyroid carcinoma with clinical and biochemical remission). Patient weight, serum free thyroid hormones, TSH, thyroglobulin (Tg), anti-Tg, and anti-thyroperoxidase antibodies were measured. Requiredl-T4dosage was evaluated. At the time of the observations, all patients presented free thyroid hormones within the normal range and TSH between 0.8 and 2 μIU/ml.ResultsPatients had undetectable Tg and anti-thyroid antibodies. The daily weight-based dosage of the replacement therapy withl-T4to reach euthyroidism in patients of group CH was significantly higher than that in those of group AH (2.16±0.36 vs 1.73±0.24 μg/kg,P<0.005). Patients of group CH treated withl-T4had significantly higher serum TSH levels than patients of group AH (P=0.05) as well as higher FT4concentrations.ConclusionsTo correct hypothyroidism, patients of group CH required a dailyl-T4dose/kg higher than group AH patients, despite higher levels of TSH. The different requirement of replacement therapy between adult patients with congenital and those with surgical athyroidism could be explained by a lack of thyroid hormones since fetal life in CH, which could determine a different set point of the hypothalamus–pituitary–thyroid axis.

Transient Prealbumin- Associated Hyperthyroxinemia in TSH-Producing Pituitary Adenoma

1990 ◽  
Vol 29 (01) ◽  
pp. 40-43 ◽  
Author(s):  
W. Langsteger ◽  
P. Költringer ◽  
P. Wakonig ◽  
B. Eber ◽  
M. Mokry ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pituitary Adenoma ◽  
Thyroid Hormones ◽  
Protein Binding ◽  
Alpha Subunit ◽  
Normal Range ◽  
Thyroxine Binding Globulin ◽  
Free Thyroid Hormones ◽  
Transmission Computed Tomography

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/ATSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

scholarly journals Long-Term Cardiovascular Effects of Levothyroxine Therapy in Young Adults with Congenital Hypothyroidism

2008 ◽  
Vol 93 (7) ◽  
pp. 2486-2491 ◽  
Author(s):  
Mariacarolina Salerno ◽  
Ugo Oliviero ◽  
Teresa Lettiero ◽  
Vincenzo Guardasole ◽  
Dario Maria Mattiacci ◽  
...  
Keyword(s):  
Young Adults ◽  
Replacement Therapy ◽  
Exercise Capacity ◽  
Congenital Hypothyroidism ◽  
Intima Media Thickness ◽  
Normal Range ◽  
Levothyroxine Replacement ◽  
Levothyroxine Treatment ◽  
Tsh Levels

Abstract Context: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients with CH. Objective: The aim of the current study was to evaluate whether long-term levothyroxine replacement therapy in young adults with CH is associated with cardiovascular abnormalities. Patients and Methods: Thirty young adults with CH aged 18.1 ± 0.2 yr and 30 age- and sex-matched controls underwent cardiac and carotid Doppler ultrasound and symptom-limited cardiopulmonary exercise testing. Hypothyroidism was diagnosed by neonatal screening, and levothyroxine treatment was initiated within the first month of life and carefully adjusted to maintain TSH levels in the normal range and free T4 in the high-normal range. Results: Compared with controls, hypothyroid patients exhibited left ventricular diastolic dysfunction, impaired exercise capacity, and increased intima-media thickness. At multiple regression analysis, the number of episodes of plasma TSH levels less than 0.5 mU/liter and greater than 4.0 mU/liter from the age of 1 yr onward, and mean TSH plasma levels during puberty were independent predictors of diastolic filling and cardiopulmonary performance indexes (multiple r values: 0.61–0.75). Conclusions: Long-term levothyroxine treatment in young adults with congenital hypothyroidism is associated with impaired diastolic function and exercise capacity and increased intima-media thickness.

scholarly journals Congenital Hypothyroidism and the Deleterious Effects on Auditory Function and Language Skills: A Narrative Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Caio Leônidas Oliveira Andrade ◽  
Crésio de Aragão Dantas Alves ◽  
Helton Estrela Ramos
Keyword(s):  
Hearing Loss ◽  
Thyroid Hormones ◽  
Congenital Hypothyroidism ◽  
Psychosocial Development ◽  
Language Skills ◽  
Auditory Function ◽  
Hearing Disorders ◽  
Endocrine Disease ◽  
Intrauterine Life ◽  
Molecular Aspects

Congenital hypothyroidism (CH) is an endocrine disease commonly found in newborns and is related to the absence or reduction of thyroid hormones (THs), which are essential for development since intrauterine life. Children with CH can develop hearing problems as THs are crucial for the auditory pathway’s development and maturation. Sensory deprivations, especially in hearing disorders at early ages of development, can impair language skills, literacy, and behavioral, cognitive, social, and psychosocial development. In this review we describe clinical and molecular aspects linking CH and hearing loss.

scholarly journals Thyroid Gene Mutations in Pregnant and Breastfeeding Women Diagnosed With Transient Congenital Hypothyroidism: Implications for the Offspring’s Health

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria C. Opazo ◽  
Juan Carlos Rivera ◽  
Pablo A. Gonzalez ◽  
Susan M. Bueno ◽  
Alexis M. Kalergis ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Congenital Hypothyroidism ◽  
Gene Mutations ◽  
Genetic Variations ◽  
Hormone Deficiency ◽  
Iodide Transport ◽  
Transport Defect ◽  
Pregnancy And Lactation ◽  
Transient Congenital Hypothyroidism

Fetus and infants require appropriate thyroid hormone levels and iodine during pregnancy and lactation. Nature endorses the mother to supply thyroid hormones to the fetus and iodine to the lactating infant. Genetic variations on thyroid proteins that cause dyshormonogenic congenital hypothyroidism could in pregnant and breastfeeding women impair the delivery of thyroid hormones and iodine to the offspring. The review discusses maternal genetic variations in thyroid proteins that, in the context of pregnancy and/or breastfeeding, could trigger thyroid hormone deficiency or iodide transport defect that will affect the proper development of the offspring.

Effects of small doses of bovine TSH on serum levels of free and total thyroid hormones, their degradation products, and diiodotyrosine

1985 ◽  
Vol 108 (2) ◽  
pp. 211-216 ◽  
Author(s):  
G. Benker ◽  
C. Splittstößer ◽  
H. Meinhold ◽  
Th. Olbricht ◽  
D. Reinwein
Keyword(s):  
Thyroid Hormones ◽  
Degradation Products ◽  
Thyroid Volume ◽  
Serum Levels ◽  
Direct Stimulation ◽  
Absolute Increase ◽  
Free Thyroid Hormones ◽  
Measurable Parameter ◽  
Small Doses ◽  
Bovine Tsh

Abstract. Bovine TSH was administered iv to 10 normal volunteers in doses of 2.5, 7.5, 15 and 30 mU/kg. Brisk elevations of serum diiodotyrosine occurred already after the smallest dose (mean, + 183%) while larger doses had only slight additional effects. T3 rose much higher than T4 (+71% compared to +23% after 15 mU bTSH/kg), and free thyroid hormones exhibited changes similar to total T3 and total T4. The mean absolute increase in serum fT3 ranged from 2.03 to 9.04 pmol/l and proved to be an easily measurable parameter for the TSH effect. Dose-response effects were seen for the increases of fT4, fT3 and T3. TBG and rT3 did not change but the degradation product 3,3'-T2 showed large increments of serum levels. There was no correlation between the response of T3 and T4, fT3 and fT4, or diiodotyrosine and any of the other parameters of thyroid function. The interindividual differences in the magnitude of thyroid hormone response to TSH were considerable, and there was no relationship between this response and thyroid volume by ultrasound. We conclude that direct stimulation of the thyroid gland with bTSH in small doses leads to consistent increases of thyroid hormones, especially T3 and fT3, that the response varies between individuals, and that the precursor diiodotyrosine is released together with thyroid hormones.

Measurement of free thyroid hormones in patients on long-term phenytoin therapy

1984 ◽  
Vol 26 (5) ◽  
pp. 633-634 ◽  
Author(s):  
J. A. Franklyn ◽  
M. C. Sheppard ◽  
D. B. Ramsden
Keyword(s):  
Thyroid Hormones ◽  
Free Thyroid Hormones

scholarly journals Rectal Atresia and Congenital Hypothyroidism: An Association or Coincidence?

2018 ◽  
Vol 06 (01) ◽  
pp. e7-e10
Author(s):  
Feride Mehmetoğlu
Keyword(s):  
Surgical Treatment ◽  
Thyroid Hormones ◽  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Anorectal Malformation ◽  
Screening Tests ◽  
Unique Case ◽  
Rectal Atresia ◽  
Three Stages

AbstractRectal atresia is a rare anorectal malformation, and its association with other anomalies is even more rare. This study presents a unique case of co-twin in which the surviving newborn male underwent surgery due to rectal atresia. Newborn screening tests identified congenital hypothyroidism. The surgical treatment consisted of three stages and thyroid hormones were replaced.

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