{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:35:57Z","timestamp":1776692157857,"version":"3.51.2"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,5,1]]},"abstract":"<jats:p>Objective. To compare the effects of therapy with thyroxine (T4) plus triiodothyronine (T3) versus T4 alone from the first days of life in screened congenital hypothyroid (CH) infants.<\/jats:p><jats:p>Methods. We examined 14 CH infants diagnosed by neonatal screening and a group of control infants. CH patients were divided randomly into 2 groups, 1 treated with T4 alone (group 1) and the other treated with T4 plus T3 (liothyronine; group 2). In all patients electrocardiography and thyroid hormone evaluations were performed before and 15 and 30 days and 3, 6, and 12 months after the beginning of therapy. Psychological tests were also performed at 6 and 12 months of age in CH patients and in other matched controls.<\/jats:p><jats:p>Results. After 15 days of treatment, serum thyrotropin (TSH) levels become normal in 5 of 7 cases of group 1 (median TSH level 10.7 \u03bcU\/ml) and in 1 of 7 cases of group 2 (median TSH level 72.5 \u03bcU\/ml). At the same period, serum-free thyroid hormone levels were within the normal range in both groups, but free T4 values were significantly higher in group 1 than in group 2 and in controls. At the subsequent examinations, free T4 values were within the upper normal limit in group 1, whereas they remained within the normal range in group 2. No clinical or electrocardiographic signs of heart disease were found in any of the patients. The psychometric quotient in CH infants was significantly lower than in controls, but similar in patients of group 1 and group 2.<\/jats:p><jats:p>Conclusions. The combined treatment with T4 plus T3 seems not to show significant advantages, at least in our experimental conditions, compared with the traditional treatment with T4 alone in early treated CH infants. A further longer and more extensive follow-up is mandatory.<\/jats:p>","DOI":"10.1542\/peds.111.5.1055","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"1055-1060","source":"Crossref","is-referenced-by-count":51,"title":["Treatment for Congenital Hypothyroidism: Thyroxine Alone or Thyroxine Plus Triiodothyronine?"],"prefix":"10.1542","volume":"111","author":[{"given":"Alessandra","family":"Cassio","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cacciari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Cicognani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grazia","family":"Damiani","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, S Orsola Hospital, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliana","family":"Missiroli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Corbelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Balsamo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milva","family":"Bal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Gualandi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2003,5,1]]},"reference":[{"key":"2021121003351362400_R1","doi-asserted-by":"crossref","unstructured":"Pilo A, Iervasi G, Vitck F, Perdeghini M, Cazzuola F, Bianchi R. Thyroidal and peripheral production of 3,5,3\u2032-triiodothyronine in humans by multicompartimental analysis. Am J Physiol.1990;258:E715\u2013E726","DOI":"10.1152\/ajpendo.1990.258.4.E715"},{"key":"2021121003351362400_R2","unstructured":"Leonard JL, Kochrle J. Intracellular pathways of iodothyronine metabolism. In: Braverman LE, Utiger RD, eds. Werner and Ingbar\u2019s The Thyroid: A Fundamental and Clinical Text. 7th ed. Philadelphia, PA: Lippincott-Raven,1996:125\u2013161"},{"key":"2021121003351362400_R3","doi-asserted-by":"crossref","unstructured":"Escobar-Morreale HF, Escobar del Rey F, Obregon MJ, Morreale de Escobar G. Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues the thyroidectomized rat. Endocrinology.1996;137:2490\u20132502","DOI":"10.1210\/endo.137.6.8641203"},{"key":"2021121003351362400_R4","doi-asserted-by":"crossref","unstructured":"MacGregor AG. Why does anybody use thyroid BP?Lancet.1961;1:329\u2013332","DOI":"10.1016\/S0140-6736(61)91498-2"},{"key":"2021121003351362400_R5","doi-asserted-by":"crossref","unstructured":"Wolter R, Noel P, de Cock P, et al. Neuropsychological study in treated thyroid disgenesis. Acta Paed Scand.1980;41(suppl 277):41\u201346","DOI":"10.1111\/j.1651-2227.1979.tb06190.x"},{"key":"2021121003351362400_R6","doi-asserted-by":"crossref","unstructured":"Glorieux J, Dussault JH, Letarte J, Guyda H, Morisette J. Preliminary results on the mental development of hypothyroid infants detected by the Quebec Screening Program. J Pediatr.1983;19:102\u2013104","DOI":"10.1016\/S0022-3476(83)80279-0"},{"key":"2021121003351362400_R7","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Genetics. Newborn screening for congenital hypothyroidism: recommended guidelines. Pediatrics.1993;91:1203\u20131209","DOI":"10.1542\/peds.91.6.1203"},{"key":"2021121003351362400_R8","doi-asserted-by":"crossref","unstructured":"Touati G, Leger J, Toublanc JE, et al. A thyroxine dosage of 8 \u03bcg\/kg per day is appropriate for the initial treatment of the majority of infants with congenital hypothyroidism. Eur J Pediatr.1997;156:94\u201398","DOI":"10.1007\/s004310050562"},{"key":"2021121003351362400_R9","doi-asserted-by":"crossref","unstructured":"Rovet JF, Ehrlich RM. Long-term effects of L-thyroxine therapy for congenital hypothyroidism. J Pediatr.1995;126:380\u2013386","DOI":"10.1016\/S0022-3476(95)70452-3"},{"key":"2021121003351362400_R10","doi-asserted-by":"crossref","unstructured":"Escobar-Monreale HF, Obregon MJ, Escobar del Rey F, Monreale de Escobar G. Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studied in thyroidectomized rats. J Clin Invest.1995;96:2828\u20132838","DOI":"10.1172\/JCI118353"},{"key":"2021121003351362400_R11","doi-asserted-by":"crossref","unstructured":"Bunevicius R, Karanavicius G, Zalinkevicius R, Prange AJ. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med.1999;340:424\u2013429","DOI":"10.1056\/NEJM199902113400603"},{"key":"2021121003351362400_R12","doi-asserted-by":"crossref","unstructured":"Cassio A, Cacciari E, Balsamo A, et al. Low growth hormone-binding protein in infants with congenital hypothyroidism. J Clin Endocrinol Metab.1998;83:3643\u20133646","DOI":"10.1210\/jcem.83.10.5173"},{"key":"2021121003351362400_R13","unstructured":"Brunet O, Lezine I. Le Development Psycologique de la Premiere Enfance. Paris, France: P.U.F.; 1951"},{"key":"2021121003351362400_R14","doi-asserted-by":"crossref","unstructured":"Silva JE, Larsen PR. Pituitary nuclear 3,5,3\u2032 triiodothyronine and thyrotropin secretion: an explanation for the effect of thyroxine. Science.1977;198:617\u2013620","DOI":"10.1126\/science.199941"},{"key":"2021121003351362400_R15","doi-asserted-by":"crossref","unstructured":"Larsen PR, Silva JE, Kaplan MM. Relationships between circulating and intracellular hormones. Endocrinol Rev.1981;2:87\u2013102","DOI":"10.1210\/edrv-2-1-87"},{"key":"2021121003351362400_R16","doi-asserted-by":"crossref","unstructured":"Silva JE, Leonard JL, Crantz FR, Larsen PR. Evidence of two tissue specific pathways for in vivo thyroxine 5\u2032-deiodination in the rat. J Clin Invest.1982;69:1176\u20131184","DOI":"10.1172\/JCI110554"},{"key":"2021121003351362400_R17","doi-asserted-by":"crossref","unstructured":"Schroder van der Elst IP, van der Heide D. Thyroxine, 3,5,3\u2032-triiodothyronine, and 3,3\u2032,5\u2032-triiodothyronine concentrations in several tissues of the rat: effects of amiodarone and desethylamiodarone on thyroid hormone metabolism. Endocrinology.1990;127:1656\u20131664","DOI":"10.1210\/endo-127-4-1656"},{"key":"2021121003351362400_R18","doi-asserted-by":"crossref","unstructured":"Toft AD. Thyroid hormone replacement\u2014one hormone or two?N Engl J Med.1999;340:469\u2013470","DOI":"10.1056\/NEJM199902113400611"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/111\/5\/1055\/1002142\/pe0503001055.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/111\/5\/1055\/1002142\/pe0503001055.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:42:15Z","timestamp":1682746935000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/111\/5\/1055\/63288\/Treatment-for-Congenital-Hypothyroidism-Thyroxine"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,5,1]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2003,5,1]]},"published-print":{"date-parts":[[2003,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.111.5.1055","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,5,1]]}}}