{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:52Z","timestamp":1790390752579,"version":"4.1.0"},"reference-count":13,"publisher":"Walter de Gruyter GmbH","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2017-0513_s_999_w2aab3b7c35b1b6b1aab1c16b1Aa\">\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Congenital hypothyroidism (CH) is the most common preventable cause of intellectual disability. The recommended starting dose of levothyroxine (LT4) is between 10 and 15 \u03bcg\/kg, an extremely wide range. We hypothesized that a sizable proportion of newborns treated for CH at the higher end of the dosage range become biochemically hyperthyroid at a follow-up visit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2017-0513_s_998_w2aab3b7c35b1b6b1aab1c16b2Aa\">\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>This study is a retrospective chart review of infants with CH between 2002 and 2012.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2017-0513_s_997_w2aab3b7c35b1b6b1aab1c16b3Aa\">\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Of the 104 patients included in this analysis, the average age at diagnosis was 11 days and the average starting dose of LT4 was 12\u00b12.5 \u03bcg\/kg. At follow-up, 36.5% required a dose reduction because of iatrogenic hyperthyroxinemia, 51% required no dose adjustment and 12.5% required a dose increase due to an elevated thyroid stimulating hormone (TSH). The starting doses of LT4 for those requiring a dose reduction, those not requiring an adjustment and those requiring an increase in the dose were 13.2\u00b12.4, 11.5\u00b12.1 and 10.3\u00b12.6 \u03bcg\/kg\/day, respectively (p\u22640.0001). Of the 34% of infants treated with an initial dose of &gt;12.5 \u03bcg\/day, 57.1% required a dose reduction at follow-up, compared to 26.1% of those whose initial starting dose was \u226412.5 \u03bcg\/kg\/day (p=0.007).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2017-0513_s_996_w2aab3b7c35b1b6b1aab1c16b4Aa\">\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Following the guidelines for initiating therapy for CH, 36.5% of the infants required a dose reduction for iatrogenic hyperthyroxinemia. These infants received a higher dose of LT4 than the infants who either required no adjustment or required an increase in the dose. A narrower range for initial dosing in CH may be appropriate.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2017-0513","type":"journal-article","created":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T22:16:39Z","timestamp":1525212999000},"page":"597-600","source":"Crossref","is-referenced-by-count":12,"title":["Does initial dosing of levothyroxine in infants with congenital hypothyroidism lead to frequent dose adjustments secondary to iatrogenic hyperthyroidism on follow-up?"],"prefix":"10.1515","volume":"31","author":[{"given":"Meghan","family":"Craven","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology , Cohen Children\u2019s Medical Center, Hofstra Northwell School of Medicine , New Hyde Park, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme R.","family":"Frank","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology , Cohen Children\u2019s Medical Center, Hofstra Northwell School of Medicine , New Hyde Park, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2018,5,1]]},"reference":[{"key":"2021021317373989893_j_jpem-2017-0513_ref_001_w2aab3b7c35b1b6b1ab2b1b1Aa","doi-asserted-by":"crossref","unstructured":"Leger J, Olivieri A, Donaldson M, Torresani T, Krude H, et al. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab 2014;99:363\u201384.","DOI":"10.1210\/jc.2013-1891"},{"key":"2021021317373989893_j_jpem-2017-0513_ref_002_w2aab3b7c35b1b6b1ab2b1b2Aa","doi-asserted-by":"crossref","unstructured":"Harris KB, Pass KA. Increase in congenital hypothyroidism in New York State and in the United States. Mol Genet Metab 2007;91:268\u201377.","DOI":"10.1016\/j.ymgme.2007.03.012"},{"key":"2021021317373989893_j_jpem-2017-0513_ref_003_w2aab3b7c35b1b6b1ab2b1b3Aa","doi-asserted-by":"crossref","unstructured":"Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis 2010;5:17.","DOI":"10.1186\/1750-1172-5-17"},{"key":"2021021317373989893_j_jpem-2017-0513_ref_004_w2aab3b7c35b1b6b1ab2b1b4Aa","doi-asserted-by":"crossref","unstructured":"Grosse SD, Van VG. 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