Epidemiology of Congenital Hypothyroidism in Markazi Province, Iran

Dorreh, Fatemeh; Chaijan, Parsa Yousefi; Javaheri, Javad; Zeinalzadeh, Ali Hossein

doi:10.4274/jcrpe.1287

Cited by 37 publications

(46 citation statements)

References 30 publications

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“…The incidence of CH is different among neonates of various countries of the world and ranges from 1:2000 to 1:4000 [2][3][4][5][6], the incidence of CH in different areas of Iran is reported to vary from 1:400 to 1:1000 [7,8].…”

Section: S S E E E E E a A A A A R R R R R C C C C C H P H P H P H P mentioning

confidence: 99%

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

et al. 2017

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Objective: To evaluate the success rate of the National newborn screening program in maintenance of intelligent quotient (IQ) of children with congenital hypothyroidism in Iran.Design: Retrospective cohort study. Methods:The IQ scores, in three subsets of verbal, non verbal (Performance) and full scale IQ, of 240 children diagnosed with Transient congenital hypothyroidism (TCH) and Permanent congenital hypothyroidism (PCH), from 5 provinces in 5 different geographical areas of Iran, were measured at the age of 6 years using revised Wechsler pre school and primary scale of intelligence and compared with 240 healthy children. We used independent sample t test and two-way ANOVA for data analysis.Results: Mean of verbal, performance, and full scale IQ scores were lower in the CH cases (permanent and transient) than the control group. Most of the IQ differences in two studied groups related to the PCH cases (P=0.005). Mean difference of IQs between children in the two groups in Yazd province (center of Iran) was higher than other provinces, and they also had significantly lower IQ than their control (healthy) children (P=0.001). No treated child had IQ<70. Conclusion:Although mean IQs of CH children was lower than their controls, IQ of all treated CH cases were close to the healthy children.Keywords: Management, Neonatal screening, Outcome. R R R R R E E E E E S S S S S E E E E E A A A A A R R R R R C C C C C H P H P H P H P H P AA A A A P P P P P E E E E E R R R R R C ongenital hypothyroidism (CH) is considered as one of the most important preventable causes of mental retardation in children [1]. The incidence of CH is different among neonates of various countries of the world and ranges from 1:2000 to 1:4000 [2-6], the incidence of CH in different areas of Iran is reported to vary from 1:400 to 1:1000 [7,8].In Iran, a National program of neonate screening was established from 2004-2005 [9]. In this program, thyroidstimulating hormone (TSH) is measured as a primary test, and positive tests are confirmed by serum thyroxine (T4). By the end of 2015, over 9 million neonates were screened and over 10 thousand children were diagnosed with CH and treated with levothyroxine (L-Thyroxine).The evaluation of this mass screening program, particularly from the view of maintaining the IQ of children with CH at the national level has been done [10,11], but there have been no systematic long-term follow-up studies for evaluation of intervention/treatment outcomes among hypothyroid children diagnosed by the nationwide newborn screening program in Iran. This study was done to assess the IQ of hypothyroid children diagnosed by national program of CH screening at age of 6 years, compared with healthy children in Iran. METHODSThis was a retrospective cohort study conducted in five provinces in different geographical areas of Iran. A total of 480 children in two study groups, including 240 children with CH and 240 healthy children were investigated in this comparative study. We first specified our samples based on mean difference sampl...

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Section: S S E E E E E a A A A A R R R R R C C C C C H P H P H P H P mentioning

confidence: 99%

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

et al. 2017

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“…The same disorders of hormone synthesis seem to explain the moderately severe nature of the delayed milestones observed in our study, although the other clinical signs were typical for hypothyroidism (1-3, 5, 22 This trend of a higher incidence of dyshormonogenesis is found in Middle East countries (19)(20)(21). Although, we identified no consanguinity among families, the fact that patients belonged to very closed families, particularly from the same village, might suggest the presence of similar genetic characteristics and explain the predominance of dyshormonosynthesis in our study population (1)(2)(3)20).…”

Section: Discussionmentioning

confidence: 54%

Dyshormonogenesis seems to be more frequent in a group of Cameroonian children with congenital hypothyroidism

Sap¹,

Koki²,

Dongmo³

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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Congenital hypothyroidism is a main congenital endocrine disorder, affecting 1 in 4000 births. It is not well described in sub-Saharan countries, and to draw attention to that issue, we decided to describe affected pediatric patients. We retrospectively analyzed the records of eight patients over a period of 6 years. We analyzed clinical sings of hypothyroidism and psychomotor development; hormonal assays and thyroid ultrasound were performed. We included four boys and four girls aged from 3 to 84 months at diagnosis with a median thyroid-stimulating hormone (TSH) level of 156.5 mUI/L. All except one present with a moderate psychomotor delay. Other clinical signs were classical for hypothyroidism. Thyroid ultrasound performed showed a goiter in half of patients, a normal gland in three of them and a hypoplasic gland in the last one, consonant with dyshormonogenesis. We therefore concluded that dyshormonogenesis seems to be more frequent in our context, and this raised the issue of neonatal screening of hypothyroidism in Africa.

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“…However, a two-fold increase in the prevalence of CH has been reported by six Newborn Screening Programs around the world, after lowering the TSH cutoff [9]. In Iran, where the TSH cutoff is 5 mIU/L whole blood, the estimated birth prevalence of CH is as high as 1/307 live births [19].…”

Section: Discussionmentioning

confidence: 99%

Impact of Lower Screening TSH Cutoff Level on the Increasing Prevalence of Congenital Hypothyroidism

Anastasovska

Kočova²

2017

IJNS

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Lower cutoff levels in screening programs have led to an increase in the proportion of detected cases of transient hypothyroidism, leading to an increase in the overall prevalence of primary congenital hypothyroidism (CH) in several countries. We have performed a retrospective evaluation on the data from 251,008 (96.72%) neonates screened for thyroid-stimulating hormone (TSH) level in dried blood spot specimens taken 48 h after birth, between 2002 and 2015, using the DELFIA method. A TSH value of 15 mIU/L whole blood was used as the cutoff point until 2010 and 10 mIU/L thereafter. Primary CH was detected in 127 newborns (1/1976) of which 81.1% had permanent and 18.9% had transient CH. The prevalence of primary CH increased from 1/2489 before 2010 to 1/1585 thereafter (p = 0.131). However, the prevalence of permanent CH increased only slightly (p = 0.922), while the transient CH prevalence showed an 8-fold increase after lowering the TSH cutoff level (p < 0.001). In cases of permanent CH, we observed a lower prevalence of thyroid dysgenesis (82.7% vs. 66.7%) and a higher prevalence of a normal in situ thyroid gland (17.3% vs. 33.3%), for the period with a lower TSH cutoff value. Our findings support the impact of a lower TSH cutoff on the increasing prevalence of congenital hypothyroidism.

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Epidemiology of Congenital Hypothyroidism in Markazi Province, Iran

Cited by 37 publications

References 30 publications

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

Intelligence Quotient at the Age of Six years of Iranian Children with Congenital Hypothyroidism

Dyshormonogenesis seems to be more frequent in a group of Cameroonian children with congenital hypothyroidism

Impact of Lower Screening TSH Cutoff Level on the Increasing Prevalence of Congenital Hypothyroidism

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