{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:16:16Z","timestamp":1783664176400,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to generate hypotheses on the effectiveness and safety of pre-treatment thyroid volume as an adjunctive parameter for guiding initial levothyroxine (L-T4) dosing in children with congenital hypothyroidism (CH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included children diagnosed with CH at Huizhou First Maternal and Child Health Hospital (2021\u20132023). Based on first follow-up ultrasound thyroid volume, patients were divided into reduced (A,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), normal (B,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948), and enlarged (C,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) groups. Initial L-T4 doses were 11\u201313\u2005\u03bcg\/kg\/d (A), 6\u20139 (B), and 9\u201311 (C). Outcomes included time to thyroid function normalization, L-T4 dose requirements, physical growth, and Gesell Developmental Quotient (DQ) up to 24 months of age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At screening and before treatment, both Group A and Group C had significantly higher TSH levels and lower FT4 levels than Group B (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In Group C, thyroid volume showed a significant positive correlation with pre-treatment TSH (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.705,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and a non-significant negative correlation with FT4 (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.440,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.060). The median time to TSH normalization was 28 days (IQR 28\u201329.75) in Group A, 14 days (IQR 14\u201314) in Group B, and 14 days (IQR 14\u201328) in Group C; FT4 normalization was achieved at 14 days in all groups. Although there were significant differences in L-T4 dose requirements among the three groups (Group A\u2009&amp;gt;\u2009Group C\u2009&amp;gt;\u2009Group B), no significant differences in body weight, length\/height, or DQ were observed between any CH group and the healthy control group within 24 months of age (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that children with CH and abnormal thyroid volume may require higher initial L-T4 doses and a longer time to TSH normalization. Based on these observations, we propose the following hypothesis: thyroid volume, as an adjunct to thyroid function tests in guiding initial dosing regimens, holds certain research value in clinical practice. Future prospective, multicenter, and large-sample studies are required to validate this hypothesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1893332","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:39:52Z","timestamp":1783661992000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Value of thyroid volume as a complementary indicator for initial levothyroxine dosing in congenital hypothyroidism: a retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuling","family":"Zhang","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]},{"name":"Newborn Disease Screening Center, Huizhou First Maternity and Child Health Hospital","place":["Huizhou, Guangdong, 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