Köhler B, Schnabel D, Biebermann H, Gruters A
Department of Pediatric Endocrinology, Klinikum Rudolf Virchow, Humboldt University of Berlin, Germany.
J Clin Endocrinol Metab. 1996 Apr;81(4):1563-7. doi: 10.1210/jcem.81.4.8636368.
Since the introduction of screening programs for congenital hypothyroidism, transient disturbances of thyroid function, especially transient congenital hypothyroidism and hyperthyrotropinemia, mostly due to iodine deficiency or contamination have been observed with variable frequencies. This study was carried out to reevaluate the thyroid function and physical development of 61 schoolchildren with transient congenital hypothyroidism or transient congenital hyperthyrotropinemia. Abnormalities were observed in 3 children. Thyroid function and growth were normal in all children, except 2 with moderately elevated TSH levels at the age of 7.7 and 10 yr in the presence of normal thyroid hormone levels. In 1 child, the TSH elevation was due to an ectopic hemithyroidea; in the other child, an unknown familial cause was suggested. In 1 girl (aged 12 yr), a euthyroid goiter caused by autoimmune thyroiditis was detected. We conclude from our investigation that frequent monitoring of thyroid function in children with transient congenital hypothyroidism or transient congenital hyperthyrotropinemia is not necessary during childhood if, postnatally, thyroid function recovered spontaneously. However, the growth and development of children with neonatal thyroid dysfunction should be followed, and if abnormalities occur, thyroid function tests are essential.
自从开展先天性甲状腺功能减退症筛查项目以来，已经观察到甲状腺功能的短暂紊乱，尤其是短暂性先天性甲状腺功能减退症和高促甲状腺素血症，其大多由碘缺乏或污染所致，出现频率各不相同。本研究旨在重新评估61例患有短暂性先天性甲状腺功能减退症或短暂性先天性高促甲状腺素血症的学龄儿童的甲状腺功能和身体发育情况。3名儿童出现了异常情况。除2名儿童在7.7岁和10岁时促甲状腺素水平中度升高而甲状腺激素水平正常外，所有儿童的甲状腺功能和生长均正常。在1名儿童中，促甲状腺素升高是由于异位半甲状腺；在另1名儿童中，提示存在不明家族性病因。在1名12岁女孩中，检测到由自身免疫性甲状腺炎引起的甲状腺功能正常的甲状腺肿。我们从调查中得出结论，如果出生后甲状腺功能自发恢复，那么在儿童期对患有短暂性先天性甲状腺功能减退症或短暂性先天性高促甲状腺素血症的儿童进行甲状腺功能的频繁监测是不必要的。然而，新生儿甲状腺功能障碍儿童的生长发育应予以跟踪，如果出现异常，甲状腺功能检查至关重要。
