Screening very-low-birthweight infants for congenital hypothyroidism

Mitchell, Marvin L.; Walraven, C.; Rojas, D.A.; McIntosh, Karen; Hermos, R J

doi:10.1016/s0140-6736(94)90918-0

Cited by 35 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The estimated total volume of our patient's thyroid gland (volume of one lobe = p/6 Â depth Â length Â width) was 0.745 mL, similar to the volume observed in full-term newborns [13,14] but about 40% higher than the thyroid volume measured in preterm infants [15]. Whereas a normal TSH on day 4 virtually rules out permanent congenital hypothyroidism in a full-term neonate, a delayed rise in TSH (up to the second month of life) has sometimes been reported in premature, very-low-birth weight infants with permanent hypothyroidism [16] so that the normal screening for congenital hypothyroidism did not rule out this possibility in our patient. However, in the present case, the association of a normal TSH screening as well as the presence of a thyroid gland in normal location by ultrasound made the diagnosis of thyroid dysgenesis unlikely.…”

Section: Discussionsupporting

confidence: 66%

Iodine overload and severe hypothyroidism in a premature neonate

Khashu

Chessex

Chanoine

2005

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 66%

Iodine overload and severe hypothyroidism in a premature neonate

Khashu

Chessex

Chanoine

2005

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…Several studies have generated data that argue for multiple sampling in preterm neonates with a GA of less than 37 weeks, LBW and very LBW neonates, ill and preterm neonates admitted to NICU, infants from whom a specimen is collected within the first 24 hours of life, and neonates from multiple births, particularly in case of monozygotic twins [8,9,12,17,19,25,26,27,28,29]. This approach reflects concern that primary CH may be masked in these situations due to the suppression of TSH caused by drug administration [30,31], by hypothalamic-pituitary immaturity [32], by fetal blood mixing in multiple births [33], and by other effects of serious neonatal illnesses [34,35,36].…”

Section: 3 Screening In Special Categories Of Neonates At Risk Of Chmentioning

confidence: 99%

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Léger¹,

et al. 2014

View full text Add to dashboard Cite

Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T₄ supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy.

show abstract

“…TT 4 levels, however, vary inversely with the severity of neonatal illness [35][36][37]. Serum FT 4 levels typically re-equilibrate to cord blood values or higher within 1 week after birth, yet TT 4 can remain depressed for as long as 3-4 weeks [16,73,74]. Considering these patterns, the task of defining the 'normal neonatal thyroid hormone level over time' in ELGANs is difficult because it depends upon a combination of gestational age, postnatal age, maturational state and severity of illness factors.…”

Section: Defining a Physiologically Appropriate Thyroid Hormone Bloodmentioning

confidence: 99%

Clinical importance of hypothyroxinemia in the preterm infant and a discussion of treatment concerns

Gamma

Paneth

2012

Current Opinion in Pediatrics

View full text Add to dashboard Cite

With 25 000 neonates born in less than 28 weeks each year in the USA, the economic impact of the very high rates of cognitive disabilities and related neurological dysfunction in survivors is substantial. The lifetime direct and indirect costs of CP are estimated at US$1 million per person and the costs of mental retardation are even higher. If reversal of transient hypothyroxinemia proves effective in reducing the risks of CP or mental retardation in ELGANs by 30%, we estimate an overall saving of US$ 3 billion per year. There is a pressing need for a phase III trial of thyroid hormone that is of sufficient duration and size to determine whether a clinically important reduction in risk of developmental impairments in ELGANs can be achieved.

show abstract

Screening very-low-birthweight infants for congenital hypothyroidism

Cited by 35 publications

References 0 publications

Iodine overload and severe hypothyroidism in a premature neonate

Iodine overload and severe hypothyroidism in a premature neonate

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Clinical importance of hypothyroxinemia in the preterm infant and a discussion of treatment concerns

Contact Info

Product

Resources

About