Neonatal screening for congenital hypothyroidism in Hessen, Germany: efficiency of the screening program and school achievement of 129 children at an age of 8–12 years

Höpfner, S.; Höpfner, B; Rauterberg, E. W.

doi:10.1515/jpm.2005.097

Cited by 9 publications

(2 citation statements)

References 21 publications

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“…All these cases should be treated as CH for the first 3 years of life by taking into account the risks of mental retardation. A re-evaluation after age 3 years is needed in such patients (1,38,39,40). …”

Section: Introductionmentioning

confidence: 99%

Newborn Screening for Congenital Hypothyroidism

Büyükgebiz¹

2012

Jcrpe

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Newborn screening (NS) for congenital hypothyroidism (CH) is one of the major achievements in preventive medicine. Most neonates born with CH have normal appearance and no detectable physical signs. Hypothyroidism in the newborn period is almost always overlooked, and delayed diagnosis leads to the most severe outcome of CH, mental retardation, emphasizing the importance of NS. Blood spot thyroid stimulating hormone (TSH) or thyroxine (T4) or both can be used for CH screening. The latter is more sensitive but not cost-effective, so screening by TSH or T4 is used in different programs around the world. TSH screening was shown to be more specific in the diagnosis of CH. T4 screening is more sensitive in detecting especially those newborns with rare hypothalamic-pituitary-hypothyroidism, but it is less specific with a high frequency of false positives mainly in low birth weight and premature infants. The time at which the sample is taken may vary. In the majority of the centers, blood is obtained from a heel prick after 24 hours of age to minimize the false positive high TSH due to the physiological neonatal TSH surge that elevates TSH levels and causes dynamic T4 and T3 changes in the first 1 or 2 days after birth. Early discharge of mothers postpartum has increased the ratio of false positive TSH elevations. Although transient hypothyroidism may occur frequently, all these infants should be treated as having CH for the first 3 years of life, taking into account the risk of mental retardation. A reevaluation after 3 years is needed in such patients. The goal of initial therapy in CH is to minimize neonatal central nervous system exposure to hypothyroidism by normalizing thyroid function, as rapidly as possible. Conflict of interest:None declared.

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Section: Introductionmentioning

confidence: 99%

Newborn Screening for Congenital Hypothyroidism

Büyükgebiz¹

2012

Jcrpe

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“…11% dieser Kinderb esuchtene ine Schule für Lernbehinderte. Derk onsequenten Begleitung einerr egelmäßigen Levothyroxineinnahme kommt also eine große Bedeutung zu(46).EinZ usammenhangz wischen individu-ellemT SH-We rt und kognitiver Leistung wurde in einerStudie vonÁlvarez-Pedrerol et alb ei Vo rschulkindern beschrieben. Auch zeigtend ie Autoren, dass Vo rschulkinder ausM enorca( n=2 89) und dem Ebrus-Gebiet in Katalonien( n=5 3) mit TSH-Konzentrationen in deroberenQuartile desReferenzbereiches einhöheresRisiko füre in ADHS (Aufmerksamkeitsdefizit-/ Hyperaktivitätssyndrom)h attena ls Kinder mit einemTSH-We rt im unterenReferenzbereich.…”

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Interactions between brain, psyche and thyroid

Schmidt

Huff²,

Dietlein³

et al. 2008

Nuklearmedizin

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SummaryInteractions between brain, psyche and thyroid are known from historical descriptions of thyroidectomy (Kocher) and hyperthyroidism. However, their importance is often underscored in clinical routine. Thyroid hormone deficiency during pregnancy may result in irreversible mental retardation and requires levothyroxine substitution. TSH screening after delivery must identify newborns with congenital hypothyroidism: An early levothyroxine substitution and long term therapy control are required.Hypothyroidism and depression have many symptoms in common. Cognitive deficits and depressive states are often found in overt hypothyroidism, psychotic derangements are rare. Levothyroxine improves hypothyroid symptoms and mental performance, mood and motivation. Psychic symptoms of hyperthyroidism include agitation, irritability, mood disturbances, hyperactivity, anxiousness and even panic attacks. Manic and delusional states are rare. In geriatric patients hyperthyroidism may be oligosymptomatic. In psychiatric patients more frequent but unspecific disturbances of thyroid laboratory values being reversible without specific therapy have to be distinguished from rather rare but causative organic thyroid diseases with therapeutic consequences. Some psychiatric drugs influence thyroid laboratory results. Hypothyroidism in depressive patients is a negative prognostic parameter and requires therapy. Psychiatric symptoms associated with hypothyroidism are usually reversible under levothyroxine within 4–8 weeks. The standard for hypothyroidism is mono-levothyroxine therapy.

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Newborn screening in Germany, Austria and Switzerland

Lukács

2009

Monatsschr Kinderheilkd

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Neugeborenenscreening in Deutschland, Österreich und der SchweizAktueller Stand Leitthema Bei vielen Stoffwechselerkrankungen können mit einer früh einsetzenden diätetischen Therapie schwere Folgeschäden verhindert und/oder eine normale Entwicklung des Kindes sichergestellt werden, so beispielsweise bei Phenylketonurie oder Hypothyreose. Dabei sind jedoch der frü-he Behandlungsbeginn und damit eine frühzeitige Diagnose entscheidend. Mit zunehmenden technischen Fortschritten konnten auch zunehmend mehr Metaboliten erfasst werden, insbesondere mit der Tandemmassenspektrometrie kann eine Vielzahl von Substanzen gleichzeitig detektiert werden. Diese sich ständig erweiterenden Möglichkeiten erfordern ebenso wie der gesellschaftlichen Wandel immer wieder eine Anpassung der Richtlinien. Im Rahmen des vorliegenden Artikels sollen die aktuelle Situation des Neugeborenenscreenings in Deutschland, Österreich und der Schweiz dargestellt und zudem kurz auf die weitere Entwicklung des Screenings in Relation zu den europäischen Nachbarländern sowie den USA eingegangen werden.

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Neonatal screening for congenital hypothyroidism in Hessen, Germany: efficiency of the screening program and school achievement of 129 children at an age of 8–12 years

Cited by 9 publications

References 21 publications

Newborn Screening for Congenital Hypothyroidism

Newborn Screening for Congenital Hypothyroidism

Interactions between brain, psyche and thyroid

Newborn screening in Germany, Austria and Switzerland

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