Intellectual outcome at 12 years of age in congenital hypothyroidism

Department of Paediatrics, University of Naples 'Federico II', Naples, Italy.

BACKGROUND: The intellectual outcome in children with congenital hypothyroidism detected by neonatal screening is generally good; however, subtle neurological dysfunctions, subnormal IQ, or both, have been reported. OBJECTIVE: To evaluate the intellectual outcome in 12-year-old patients with congenital hypothyroidism, detected by neonatal screening, in an attempt to identify factors that may affect intellectual development. METHODS: The intelligence quotient (IQ) of 40 children with congenital hypothyroidism was evaluated at 12 years of age, using the Wechsler Intelligence Scale for Children -- Revised, and compared with the IQ of 40 healthy siblings (control group). RESULTS: The mean IQ score (88.4+/-13.1) was not significantly different from that of the control group (93.4+/-10.7). Thirteen patients showed subnormal IQ score (72.4+/-4.9) compared with their siblings (86.7+/-9.6; P<0.0001) and with the other patients (96.1+/-9.6; P<0.0001). The low IQ score was associated with lower serum concentrations of thyroxine at diagnosis, poor treatment compliance during follow-up and lower familial IQ. Interviews with parents of children with congenital hypothyroidism revealed that a refusal to acknowledge the disease was linked to poor attention to the child's emotional life and to poor treatment compliance in some cases (11%). CONCLUSION: Even though the mean IQ score in patients with congenital hypothyroidism falls within normal for the control population, low IQ scores may be present in patients with severe hypothyroidism, inadequate compliance to replacement therapy during follow-up and poor parental pedagogic attitude.

This article has been cited by other articles:

				M. Salerno, U. Oliviero, T. Lettiero, V. Guardasole, D. M. Mattiacci, L. Saldamarco, D. Capalbo, A. Lucariello, L. Sacca, and A. Cittadini Long-Term Cardiovascular Effects of Levothyroxine Therapy in Young Adults with Congenital Hypothyroidism J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2486 - 2491. [Abstract] [Full Text] [PDF]

				L. van der Sluijs Veer, M. J. E. Kempers, B. F. Last, T. Vulsma, and M. A. Grootenhuis Quality of Life, Developmental Milestones, and Self-Esteem of Young Adults with Congenital Hypothyroidism Diagnosed by Neonatal Screening J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2654 - 2661. [Abstract] [Full Text] [PDF]

				M. J. E. Kempers, L. van der Sluijs Veer, M. W. G. Nijhuis-van der Sanden, L. Kooistra, B. M. Wiedijk, I. Faber, B. F. Last, J. J. M. de Vijlder, M. A. Grootenhuis, and T. Vulsma Intellectual and Motor Development of Young Adults with Congenital Hypothyroidism Diagnosed by Neonatal Screening J. Clin. Endocrinol. Metab., February 1, 2006; 91(2): 418 - 424. [Abstract] [Full Text] [PDF]

				M. J. E. Kempers, A. S. P. van Trotsenburg, D. A. van Tijn, E. Bakker, B. M. Wiedijk, E. Endert, J. J. M. de Vijlder, and T. Vulsma Disturbance of the Fetal Thyroid Hormone State Has Long-Term Consequences for Treatment of Thyroidal and Central Congenital Hypothyroidism J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4094 - 4100. [Abstract] [Full Text] [PDF]

				I. Hrytsiuk, R. Gilbert, S. Logan, S. Pindoria, and C. G. D. Brook Starting Dose of Levothyroxine for the Treatment of Congenital Hypothyroidism: A Systematic Review Arch Pediatr Adolesc Med, May 1, 2002; 156(5): 485 - 491. [Abstract] [Full Text] [PDF]

				A. Hanukoglu, K. Perlman, I. Shamis, L. Brnjac, J. Rovet, and D. Daneman Relationship of Etiology to Treatment in Congenital Hypothyroidism J. Clin. Endocrinol. Metab., January 1, 2001; 86(1): 186 - 191. [Abstract] [Full Text]