title: The Role of Thyrotropin-Releasing Hormone Stimulation Test in Management of Hyperthyrotropinemia in Infants.
abstract: OBJECTIVE
  Hyperthyrotropinemia, which can be either a permanent or a transient state, is an asymptomatic condition and there is a controversy in management and long-term consequences. The aim of this study was to evaluate the results of thyrotropin-releasing hormone (TRH) test in infants with hyperthyrotropinemia.
  
  
  METHODS
  Data of the patients who underwent a TRH test for mildly elevated thyroid-stimulating hormone (TSH) levels between 2004 and 2011 in a single academic pediatric endocrinology unit were retrospectively reviewed from the case files.
  
  
  RESULTS
  Twenty infants (13 female, 7 male) with the median (range) age of 33 days (25-50) were enrolled into the study. The median basal TSH was 7.0 mIU/L (4.9-8.9) and free thyroxine level was 1.4 ng/mL (1.2-1.6) at the time of the TRH test. Thyroid ultrasonography was performed to 10 of the cases, and one of them had thyroid hypoplasia. TRH test revealed normal results in four infants, while sixteen infants had exaggerated response suggestive of primary hypothyroidism. The median follow-up period was 3.5 years (2.3-3.7). Therapy was discontinued in seven cases (2 had normal TRH response, 5 had exaggerated response) with the median age of 3.2 years (2.5-4). Of these seven infants, three had an elevated TSH on follow-up and L-thyroxine was restarted. All of the infants, in whom therapy was restarted, had exaggerated response to TRH.
  
  
  CONCLUSIONS
  TRH test response could be a useful diagnostic test to evaluate the persistence of the disease during the infantile age period.
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, Turkey Phone: +90 533 749 88 17 E-mail: ayca.altincik@deu.edu.tr.
authors.forename: Ayça
authors.initials: A
authors.lastname: Altıncık
authors.forename: Korcan
authors.initials: K
authors.lastname: Demir
authors.forename: Gönül
authors.initials: G
authors.lastname: Çatlı
authors.forename: Ayhan
authors.initials: A
authors.lastname: Abacı
authors.forename: Ece
authors.initials: E
authors.lastname: Böber
mesh_terms: D003409:Congenital Hypothyroidism / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011388:Prolactin / Q000097:blood; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013960:Thyroid Function Tests / Q000379:methods*; D013972:Thyrotropin / Q000097:blood*; D013973:Thyrotropin-Releasing Hormone / Q000008:administration & dosage*; D013974:Thyroxine / Q000097:blood; D013997:Time Factors
chemical_list: D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin; D013972:Thyrotropin; D013974:Thyroxine
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