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Growth and maturational responses to thyroid hormones

Although congenital hypothyroidism(CH) affects linear-growth (LG), bone-maturation(BM) and brain development little data exists concerning the time needed to reverse these parameters. This study investigates LG, BM and head circumference(HC)growth (indirect index of brain growth) in infants with CH at time of diagnosis and after replacement therapy. 47 infants were studied (31-ectopia;8-agenesis;8-goiter). Follow-up was only in patients growing along a costant growth channel at least 9 months(n=21).Results: a) Delay in BM at diagnosis depends on serum levels of T4(r=+.84)and age at diagnosis(r=−.83). b) 12±2mos after therapy BM shows normal progression with respect to elapsed time with no evidence of "catch-up". c) LG is markedly impaired by the time of diagnosis(27±10days) but shows immediate "catch-up" converting into a normal velocity after 8±2mos. d) HC is not affected in the untreated CH infantin the first 2 months of life regardless of the serum T4 concentration but is markedly decreased after this time only in infants with athyreosis.Conclusion: The 3 parameters studied respond differently to presence or absence of T4 suggesting that different thresholds may exist for various thyroid-dependent functions.