Intellectual outcome at 12 years of age in congenital hypothyroidism.
BACKGROUND
The intellectual outcome in children with congenital hypothyroidism detected by neonatal screening is generally good; however, subtle neurological dysfunctions, subnormal IQ, or both, have been reported.


OBJECTIVE
To evaluate the intellectual outcome in 12-year-old patients with congenital hypothyroidism, detected by neonatal screening, in an attempt to identify factors that may affect intellectual development.


METHODS
The intelligence quotient (IQ) of 40 children with congenital hypothyroidism was evaluated at 12 years of age, using the Wechsler Intelligence Scale for Children -- Revised, and compared with the IQ of 40 healthy siblings (control group).


RESULTS
The mean IQ score (88.4+/-13.1) was not significantly different from that of the control group (93.4+/-10.7). Thirteen patients showed subnormal IQ score (72.4+/-4.9) compared with their siblings (86.7+/-9.6; P<0.0001) and with the other patients (96.1+/-9.6; P<0.0001). The low IQ score was associated with lower serum concentrations of thyroxine at diagnosis, poor treatment compliance during follow-up and lower familial IQ. Interviews with parents of children with congenital hypothyroidism revealed that a refusal to acknowledge the disease was linked to poor attention to the child's emotional life and to poor treatment compliance in some cases (11%).


CONCLUSIONS
Even though the mean IQ score in patients with congenital hypothyroidism falls within normal for the control population, low IQ scores may be present in patients with severe hypothyroidism, inadequate compliance to replacement therapy during follow-up and poor parental pedagogic attitude.
Salerno
M
M
Department of Paediatrics, University of Naples 'Federico II', Naples, Italy.
Militerni
R
R
Di Maio
S
S
Bravaccio
C
C
Gasparini
N
N
Tenore
A
A
D000223:Adaptation, Psychological; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D003409:Congenital Hypothyroidism / Q000097:blood / Q000151:congenital / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D016014:Linear Models; D008297:Male; D009679:Nuclear Family; D010287:Parent-Child Relations; D010349:Patient Compliance; D011379:Prognosis; D013963:Thyroid Hormones / Q000097:blood; D016896:Treatment Outcome
D013963:Thyroid Hormones