Paper Information

Journal:   PAJOUHESH DAR PEZESHKI   Spring 2004 , Volume 28 , Number 1; Page(s) 43 To 48.
 
Paper: 

THE HIGH PREVALENCE OF SEVERE CONGENITAL HYPOTHYROIDISM: A NECESSITY FOR AN EFFECTIVE STRATEGY OF DETECTION AND TREATMENT IN THE NATIONAL SCREENING PROGRAM FOR NEONATAL HYPOTHYROIDISM

 
 
Author(s):  ORDOUKHANI A., MIRMIRAN PARVIN, HEDAYATI S.M., RAMEZAN KHANI A., AZIZI F.
 
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Abstract: 

Background: The high prevalence of congenital hypothyroidism (CH) has been reported--previously, however the severity of CH has not been evaluated yet. This report illustrates the severity of CH in Tehran and Damavand.
Materials and methods: From February 1998 to May 2003, 31 hypothyroid neonates (>37 weeks gestation) were detected during the CH screening program in Tehran and Damavand. Neonates were grouped in permanent (n=25) and transient CH (n=6). Those in the permanent CH were assigned in Dysgenetic (n=18) and dyshormonogenetic (n=5) groups. Dysgenetic cases were further classified in ectopic-hypoplastic (n=13) and athyroitic (n=5) cases. Serum thyroxine values and frequency distribution of sever hypothyroidism (T4< 42.8 nmol/l) were compared among the groups.
Results: Mean (±SD) of T4 of permanent CH (38.0±42.2 nmol/l)was significantly lower than transient CH (101.9±46.5nmol/l) (p< 0.01). It was similar in dysgenetic (41.9±47.5nmol/l) and dyshormonogenetic (27.8±23.7nmol/l). Both latter groups showed significantly lower T4 values than transient CH (p<0.05). Athyreotic cases (11.1±5.9nmol/I) had lower T41evels than transient CH (p< 0.05). Severe CH was present in 18(72%) permanent, 1(16.7%) transiert, 8(61.5%) ectopic-hypoplastic, 5(100%) athyroitic, and 5(71.4%) dyshormonogenetic CH cases. Odds ratio of severe CH occurrence in permanent CH as compared to transient CH was 12.9(95% Cl: 1.27-130.54).
Conclusion: The high prevalence of severe CH warrants an effective national CH screening program for early detection of CH cases and sufficient replacement therapy.

 
Keyword(s): NEONATAL SCREENING, THYROXINE, HYPOTHYROIDISM
 
References: 
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