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Currently, there is a paucity of reliable markers predicting TCH at diagnosis, and the diagnosis is established following the withdrawal of levothyroxine therapy around 3 years of age. The incidence of TCH is increasing, and it is a major contributor to the overall increase in the incidence of CH in recent studies. Both genetic factors, in particular mutations affecting DUOX2 and DUOXA2, and environmental factors, for example, iodine deficiency and excess, anti- TSHR antibodies and exposure to antithyroid or iodine-rich medications, may cause TCH. Resolution of TCH in childhood may reflect both normal thyroid physiology (decreased thyroid hormone biosynthesis requirements after the neonatal period) and clearance or cessation of environmental precipitants. The relative contributions and interactions of genetic and environmental factors to TCH, and the extent to which TCH may be prevented, require evaluation in future population-based studies.<\/jats:p>","DOI":"10.1530\/eje-21-1278","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T16:48:51Z","timestamp":1652978931000},"page":"R1-R16","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":36,"title":["MECHANISMS IN ENDOCRINOLOGY: The pathophysiology of transient congenital hypothyroidism"],"prefix":"10.1093","volume":"187","author":[{"given":"Catherine","family":"Peters","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Great Ormond Street Hospital for Children , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-2884","authenticated-orcid":false,"given":"Nadia","family":"Schoenmakers","sequence":"additional","affiliation":[{"name":"University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge , Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"2023010809170950800_bib1","doi-asserted-by":"crossref","first-page":"R297","DOI":"10.1530\/EJE-18-0383","article-title":"DIAGNOSIS OF ENDOCRINE DISEASE: Congenital hypothyroidism: update and perspectives","volume":"179","author":"Peters","year":"2018","journal-title":"European Journal of Endocrinology"},{"key":"2023010809170950800_bib2","doi-asserted-by":"crossref","first-page":"4428","DOI":"10.1210\/jc.2018-00362","article-title":"Permanent vs transient congenital hypothyroidism: assessment of predictive variables","volume":"103","author":"Oron","year":"2018","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"2023010809170950800_bib3","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1089\/thy.2020.0333","article-title":"Congenital hypothyroidism: a 2020\u20132021 consensus guidelines update-an endo-European reference network initiative endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology","volume":"31","author":"van Trotsenburg","year":"2021","journal-title":"Thyroid"},{"key":"2023010809170950800_bib4","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/j.1365-2265.2009.03568.x","article-title":"A 7-year experience with low blood TSH cutoff levels for neonatal screening reveals an unsuspected frequency of congenital hypothyroidism (CH)","volume":"71","author":"Corbetta","year":"2009","journal-title":"Clinical Endocrinology"},{"key":"2023010809170950800_bib5","doi-asserted-by":"crossref","first-page":"100.e4","DOI":"10.1016\/j.annepidem.2015.11.005","article-title":"Increased incidence of congenital hypothyroidism in France from 1982 to 2012: a nationwide multicenter analysis","volume":"26","author":"Barry","year":"2016","journal-title":"Annals of Epidemiology"},{"key":"2023010809170950800_bib6","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00431-015-2630-5","article-title":"Changes in the incidence and etiology of congenital hypothyroidism detected during 30 years of a screening program in central Serbia","volume":"175","author":"Mitrovic","year":"2016","journal-title":"European Journal of Pediatrics"},{"key":"2023010809170950800_bib7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.4274\/jcrpe.2345","article-title":"Transient congenital hypothyroidism in turkey: an analysis on frequency and natural course","volume":"8","author":"Kara","year":"2016","journal-title":"Journal of Clinical Research in Pediatric Endocrinology"},{"key":"2023010809170950800_bib8","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1210\/jc.2011-1073","article-title":"Is the incidence of congenital hypothyroidism really increasing? 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