Yıl: 2021 Cilt: 13 Sayı: 3 Sayfa Aralığı: 269 - 275 Metin Dili: İngilizce DOI: 10.4274/jcrpe.galenos.2020.2020.0194 İndeks Tarihi: 03-12-2021

Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism

Öz:
Objective: Initial high-dose sodium levothyroxine (Na-LT4 ) (10-15 μg/kg/day) replacement for primary congenital hypothyroidism (CH) is recommended in guidelines. However, high-dose Na-LT4risks iatrogenic hyperthyroidism. The aim of this study was to investigate the normalizing effect of varying initial doses of Na-LT4on serum thyroid hormone levels. Methods: Fifty-two patients were analyzed retrospectively. The patients were classified into mild (27/51.9%), moderate (11/21.1%) and severe (14/26.9%) CH, based on initial free thyroxine (fT4 ) levels. Time taken to achieve target hormone levels was compared within groups. Results: Initial mean Na-LT4doses for mild, moderate and severe disease were 6.9±3.3, 9.4±2.2 and 10.2±2 μg/kg/day. Serum fT4 levels reached the upper half of normal range (>1.32 ng/dL) in a median of 16, 13 and 16 days in patients with mild, moderate and severe CH with the mean time from initial treatment to first control visit of 14.8±6 days (range 1-36). There was no significant difference in terms of time to achieve target fT4hormone levels according to disease severity (p=0.478). Seven (25.9%), eight (72.7%) and eight (57.1%) patients experienced hyperthyroxinemia (serum fT4>1.94 ng/dL) in the mild, moderate, and severe CH groups at the first visit, respectively (p=0.016). Conclusion: Not all patients diagnosed with CH require high-dose Na-LT4 . Initial dose of Na-LT4may be selected on the basis of pretreatment thyroid hormone levels. Some patients with moderate and severe CH, experienced iatrogenic hyperthyroxinemia even though the dose was close to the lower limit of the recommended range in guidelines. We suggest that lower initial doses may be appropriate with closer follow-up within the first week.
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APA günbey c, Özön Z, Gonc E, ALIKASIFOGLU A, Karahan S, Kandemir N (2021). Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. , 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
Chicago günbey ceren,Özön Z. Alev,Gonc E. Nazli,ALIKASIFOGLU AYFER,Karahan Sevilay,Kandemir Nurgun Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. (2021): 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
MLA günbey ceren,Özön Z. Alev,Gonc E. Nazli,ALIKASIFOGLU AYFER,Karahan Sevilay,Kandemir Nurgun Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. , 2021, ss.269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
AMA günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. . 2021; 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
Vancouver günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. . 2021; 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
IEEE günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N "Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism." , ss.269 - 275, 2021. 10.4274/jcrpe.galenos.2020.2020.0194
ISNAD günbey, ceren vd. "Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism". (2021), 269-275. https://doi.org/10.4274/jcrpe.galenos.2020.2020.0194
APA günbey c, Özön Z, Gonc E, ALIKASIFOGLU A, Karahan S, Kandemir N (2021). Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology, 13(3), 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
Chicago günbey ceren,Özön Z. Alev,Gonc E. Nazli,ALIKASIFOGLU AYFER,Karahan Sevilay,Kandemir Nurgun Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology 13, no.3 (2021): 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
MLA günbey ceren,Özön Z. Alev,Gonc E. Nazli,ALIKASIFOGLU AYFER,Karahan Sevilay,Kandemir Nurgun Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology, vol.13, no.3, 2021, ss.269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
AMA günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology. 2021; 13(3): 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
Vancouver günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology. 2021; 13(3): 269 - 275. 10.4274/jcrpe.galenos.2020.2020.0194
IEEE günbey c,Özön Z,Gonc E,ALIKASIFOGLU A,Karahan S,Kandemir N "Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism." Journal of Clinical Research in Pediatric Endocrinology, 13, ss.269 - 275, 2021. 10.4274/jcrpe.galenos.2020.2020.0194
ISNAD günbey, ceren vd. "Basal Serum Thyroxine Level should Guide Initial Thyroxine Replacement Dose in Neonates with Congenital Hypothyroidism". Journal of Clinical Research in Pediatric Endocrinology 13/3 (2021), 269-275. https://doi.org/10.4274/jcrpe.galenos.2020.2020.0194