Serum thyrotrophin determination on day 5 of life as screening procedure for congenital hypothyroidism.

Delange, François; Camus, Marguerite; Winkler, Moritz; Dodion, J; Ermans, A. M.

doi:10.1136/adc.52.2.89

Cited by 56 publications

(14 citation statements)

References 40 publications

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“…Initially, most programs in North America, some in Europe, and those in Australia, New Zealand, and Israel employed a primary T4 test, with a follow-up TSH measurement in infants with a T4 below a selected cutoff, typically <10th percentile (Fisher et al, 1979, LaFranchi et al, 1979. Other programs in Europe and Japan employed a primary TSH test strategy (Illig et al, 1977;Delange et al, 1977, Miyai et al,1978. These programs reported an incidence of CH of approximately 1:4,000 newborns.…”

Section: History and Evolution Of Newborn Screening Test Strategies Fmentioning

confidence: 96%

Newborn screening strategies for congenital hypothyroidism: an update

LaFranchi

2010

J of Inher Metab Disea

107

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It is the purpose of this article to briefly review the initial development and subsequent evolution of newborn screening programs to detect infants with congenital hypothyroidism (CH) and then to provide an update of the advantages and disadvantages of the main test strategies. Pilot programs began screening newborn populations in North America in the mid-1970s using either primary thyroxine (T4)-follow-up thyroid stimulating hormone (TSH) or primary TSH testing. Many programs in the United States and around the world continue to prefer a primary T4-follow-up TSH test strategy. This approach has the advantage of detecting infants with primary CH, as well as cases of hypopituitary hypothyroidism, by follow-up of infants with a T4 below an absolute cutoff or with a persistently low T4 level, necessitating a higher recall rate. With increasing assay sensitivity and specificity, several programs in the United States and worldwide have elected to switch to a primary TSH test strategy. This test strategy has the advantage of detecting primary CH and subclinical hypothyroidism and at a lower recall rate. Programs considering switching to a primary TSH test strategy need to develop age-related TSH cutoffs to maintain an acceptable recall rate. Both test strategies have the potential to detect infants with CH characterized by "delayed TSH rise," but only if they collect a routine or discretionary second specimen, now recommended in low-birth-weight and acutely ill infants. Lastly, a lower TSH cutoff appears to be one of the explanations for the recently described increased incidence of CH.

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Section: History and Evolution Of Newborn Screening Test Strategies Fmentioning

confidence: 96%

Newborn screening strategies for congenital hypothyroidism: an update

LaFranchi

2010

J of Inher Metab Disea

107

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“…The personal experience of the author in neonatal thy roid screening has been the simultaneous determination of both serum TSH and T4 during the very early phase of the implementation of the program [10]. The cutoff point for TSH was initially set at 12 pU/ml of serum in order to detect any condition resulting in neonatal thyroid overstimulation.…”

Section: Neonatal Thyroid Screeningmentioning

confidence: 99%

Neonatal Screening for Congenital Hypothyroidism Results and Perspectives

Delange¹

1997

Horm Res

200

110

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Systematic screening for congenital hypothyroidism in the neonate constitutes a major progress in the prevention of mental retardation, as the condition occurs in 1/4,000 newborns and necessarily results in brain damage if not properly detected and treated during the first days of life. Screening and diagnostic and therapeutic procedures are discussed, as well as outcome and prognosis of the affected infants. Primary thyroid-stimulating hormone screening is almost universally recommended. Early therapy (within 14 days) with appropriate doses of thyroxine (about 10 µg/kg/day) will prevent any brain damage even in case of evidence of fetal hypothyroidism, as thyroxine of maternal origin will reach the fetus and largely protect him. Neonatal thyroid screening is also a particularly sensitive monitoring tool in the evaluation of the effects and of the correction of iodine deficiency at the population level.

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“…Following the publication of Dussault et al [28] in 1975, other programs based on this assay sprung throughout the industrialized world. However, the situation became more complex and controversial when other investigators evaluated the measurement of thyrotropin (TSH) on these same filter paper samples for the same purpose [29]. For a number of years, the proponents of the TT 4 and TSH approaches argued about the advantages of each method.…”

Section: Biochemical Screening For Congenital Hypothyroidismmentioning

confidence: 99%