ECE2019 Guided Posters Benign Thyroid Disorders (11 abstracts)
Do different initial doses of L-T4 within the range of 10–15 mcg/kg/die influence neurodevelopment during the first two years of life in children with congenital hypothyroidism?
Cristina Moracas 1 , Gian Paolo Ciccarelli 1 , Carmela Bravaccio 1 , Alessandra Cassio 2 , Roberto Gastaldi 3 , Alessandro Mussa 4 , Miriam Polizzi 1 , Maria Cristina Vigone 5 , Malgorzata Gabriela Wasniewska 6 , Giovanna Weber 5 & Mariacarolina Salerno 1
1Pediatric Endocrine Unit, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy; 2Pediatric Department, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 3Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy; 4Department of Pediatrics and Public Health, Regina Margherita Children’s Hospital, University of Turin, Turin, Italy; 5Department of Pediatrics, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy; 6Department of Pediatrics, University of Messina, Messina, Italy.
Background: The initial L-T4 dose in the treatment of congenital hypothyroidism (CH) currently recommended is 10–15 mcg/kg/die.
Objective: We designed a multicenter randomized trial to evaluate the effects of different starting dose of L-T4 within the range 10–15 mcg/kg/die on neurocognitive development in children with CH.
Methods: Seventy-two children with CH diagnosed by neonatal screening were enrolled in the study. They were randomly assigned to receive an initial L-T4 dose of 10–12.5 mcg/kg/die (group A) or 12.6–15 mcg/kg/die (group B). All patients underwent clinical examination and FT4 and TSH measurement periodically during the first two years of life. At the age of 12 and 24 months they underwent Griffiths Mental Development Scales to evaluate cognitive development.
Results: Growth during the first two years of life was comparable in the two groups of patients. Neurodevelopmental evaluation showed no significant difference in Global and Subscales Quotients between the two groups – at 12 and at 24 months of age (Table 1).
| Group A | Group B | P | |
| Global Developmental Quotient 12 months | 105.2±12.6 | 104.5±12.8 | Ns |
| Locomotion DQ | 99.1±14.7 | 96.7±18.4 | Ns |
| Personal/social DQ | 97.7±13.7 | 102.2±13.3 | Ns |
| Language DQ | 109.1±10.8 | 107.3±14.6 | Ns |
| Eye-hand coordination DQ | 107.6±17.5 | 104.4±17.8 | Ns |
| Performance DQ | 109.5±19.9 | 109.8±20.6 | Ns |
| Global Developmental Quotient 24 months | 96.9±16.6 | 100.6±16 | Ns |
| Locomotion DQ | 109.1±23.3 | 111.8±22.1 | Ns |
| Personal/social DQ | 93.3±25.3 | 99.9±21.4 | Ns |
| Language DQ | 87.7±21.7 | 91.2±20.1 | Ns |
| Eye-hand coordination DQ | 100.7±17.5 | 104.4±13.5 | Ns |
| Performance DQ | 102.4±15.4 | 105.4±15 | Ns |
Conclusion: Different initial doses of L-T4 within the range of 10–15 mcg/kg/die are not associated with differences in neurodevelopment during the first two years of life in CH patients.
Volume 63
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