Abstract
Cerebral atrophy with sella turcica alterations have been found in adult patients with primary hypothyroidism, who started replacement therapy after one year of age. Only one report described demyelinating processes in a 14 months old untreated girl, that presented a development delay.
The aim of our study was to investigate the CNS morphology and myelination with Magnetic Resonance Images (MRI) in congenital hypothyroidism (CH) detected by neonatal screening before replacement therapy.
We studied 7 CH infants, 5 girls and 2 boys, mean age 21 days, 4 agenetic and 3 ectopic. Beclard's nucleus was absent in 2 patients, mean T4 concentration at diagnosis was 22.2 ng/mL (n.v.: 50-115 ng/mL), As normal controls 22 term newborns (38-41 weeks of gestational age) were studied.
MRI studies were performed with a 1.5 T magnet, extremity coil, T1 - weighted and heavily T2 - sequences. In all patients and controls a complete set of T1 and T2 - weighted axial sections were obtained. No sedation was needed for the MRI studies.
Brain MRI examination was normal in all patients compared to controls. In particular no differences in the myelination patterns of the brain were observed between normal subjects and patients with hypothyroidism. The ventricles and the subarachnoid spaces showed a normal size.
Our study shows no morphologic brain abnormalities in CH infants delected by neonatal screening before replacement therapy. Perinatal hypothyroidism seems to have no effect on CNS structures.
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Sinigusa, V., Triulzi, F., Weber, G. et al. BRAIN MRI IN CONGENITAL HYPOTHYROID INFANTS AT DIAGNOSIS. Pediatr Res 33 (Suppl 5), S91 (1993). https://doi.org/10.1203/00006450-199305001-00530
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DOI: https://doi.org/10.1203/00006450-199305001-00530