| Research Abstract |
In rat experiments, congenital hypothyroidism (CH) rats were measured for their serum TSH and free thyroxine (FT4) levels at the age of 9 months. The values were all within normal ranges, which suggested their thyroid functions were normalized. Thirteen border-line CH neonates (blood TSH values, 20.75±21.32μIU/l) were treated with 1-thyroxine (LT4) (5 μg/kg of body weight/day) and their thyroid hormone levels were kept within normal ranges up to the cessation of the LT4 treatment at the ages of 18.8±14.4 months. Their thyroid hormone levels were measured 12.2±12.4 months after the cessation of LT4 treatment : TSH, 2.99±1.66μIU/l ; and FT4,2.34±2.97μg/dl, which were all within normal ranges. This showed that the early treatment of border-line CH neonates with LT4 do not disturb thyroid functions. (Asami T, et al. Acta Paediatr, 2004). In another study, we found the seasonality in the incidence of CH that the highest incidence of CH was in February and the lowest incidence was in May. Th
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e number of CH patients in winter was the largest among the four seasons. seasonal variation of chemical compounds in the environment may play some role in the seasonality (Nakamizo M, Asami T, et al. J Paediatr Child Health, 2005)). In order to assess the relationship between the clinical findings before starting treatment and the development quotient (DQ) in children treated foe CH. 129 CH patients were divided into favorable and unfavorable groups according to intellectual performance. CH children tend to have a similar intellectual outcome to those of normal children. However, a low birth weight, the presence of complications and a high serum TSH value are the risk factors for unfavorable cases who consistently have a DQ score of less than 100 (Nakamizo M, Asami T, et al. Clinical Pediatrics, 2006 in press). Finally, we clarified the long-term consequences of early-treated CH patients. Of the 109 screening-detected CH patients, 63 are now attending primary schools, 28,junior high schools, six, senior high schools, one, job-oriented school, and three, university. Of the remaining patients, one is a house wife having two children, and seven are working at various companies. From these results it is concluded that the early treatment of border-line CH neonates with LT4 do not have harmful effect on thyroid functions in later life. I strongly recommend this early treatment of border-line CH infants.. Less
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