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Hyperthyrotropinemia at two weeks of age indicates thyroid dysfunction and predicts the occurrence of delayed elevation of thyrotropin in very low birth weight infants.
MedLine Citation:
PMID:  22168665     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  For preterm infants, transient hypothyroxinemia of prematurity (THOP) and transient primary hypothyroidism, especially with delayed elevation of serum thyrotropin (TSH), are important. Methods:  In order to address the above two issues, we performed thyrotropin-releasing hormone (TRH) stimulation tests at about 2 weeks of age for 31 preterm infants with a gestational age of 30 weeks or less. Results:  For basal TSH levels, 68% of infants (21 of 31) showed normal values (TSH<10mU/L) and 32% of infants (10 of 31) showed higher values (4 infants: TSH 10-15mU/L, 6 infants: TSH>15mU/L). Peak TSH values in response to TRH stimulation tests ranged from 9.76mU/L to 114.8mU/L. All infants showed a significant response to TRH stimulation tests. Only 9.5% of infants (2 of 21) with normal basal TSH values showed a hyper-response (peak TSH>45mU/L), whereas 80% of infants (8 of 10) who had higher basal TSH values showed a hyper-response. All infants who showed mildly elevated basal TSH values (TSH 10-15mU/L) and a hyper-response to TRH stimulation tests showed delayed elevation of basal TSH values (TSH>15mU/L) later. Conclusions:  TRH stimulation tests at about two weeks of age suggested that the hypothalamic-pituitary-thyroid axis might be established even in extremely premature infants. Basal increased TSH levels (TSH>10mU/L) and a hyper-response to TRH stimulation tests (peak TSH>45mU/L) suggested subclinical thyroid dysfunction. Serum TSH values at about two weeks of age could be useful for the prediction of delayed TSH elevation. © 2011 Blackwell Publishing Ltd.
Authors:
Fusako Niwa; Masahiko Kawai; Hoshinori Kanazawa; Kougorou Iwanaga; Takashi Matsukura; Takeshi Hasegawa; Toshio Heike
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-15
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Kyoto University.
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