The Continuing Health Burden of Congenital Hypothyroidism in the Era of Neonatal Screening

Vliet, Guy Van; Grosse, Scott D.

doi:10.1210/jc.2011-0687

Cited by 13 publications

(7 citation statements)

References 20 publications

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“…In the pre-NBS era, as many as one-fourth of children with clinically diagnosed, overt CH developed mild-to-moderate intellectual disability and received special schooling (1). With NBS and timely and appropriate treatment, children with CH no longer require special education services, (68) although behavioral problems are sometimes reported (69). …”

Section: Discussionmentioning

confidence: 99%

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

Lain

Trumpff

Grosse

et al. 2017

European Journal of Endocrinology

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When newborn screening (NBS) for congenital hypothyroidism (CH) using thyroid-stimulating hormone (TSH) as a primary screening test was introduced, typical TSH screening cutoffs were 20–50 U/L of whole blood. Over the years, lowering of TSH cutoffs has contributed to an increased prevalence of detected CH. However, a consensus on the benefit deriving from lowering TSH cutoffs at screening is lacking. The present paper outlines arguments both for and against the lowering of TSH cutoffs at NBS. It includes a review of recently published evidence from Australia, Belgium and Italy. A section focused on economic implications of lowering TSH cutoffs is also provided. One issue that bears further examination is the extent to which mild iodine deficiency at the population level might affect the association of neonatal TSH values with cognitive and developmental outcomes. A debate on TSH cutoffs provides the opportunity to reflect on how to make NBS for CH more effective and to guarantee optimum neurocognitive development and a good quality of life to babies with mild as well as with severe CH. All authors of this debate article agree on the need to establish optimal TSH cutoffs for screening programs in various settings and to ensure the benefits of screening and access to care for newborns worldwide.

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Section: Discussionmentioning

confidence: 99%

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

Lain

Trumpff

Grosse

et al. 2017

European Journal of Endocrinology

Self Cite

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“…51 By contrast, it is difficult to justify population TSH screening for hypothyroidism in mature age men and women without any evidence of benefit from randomised controlled trials or cost benefit analyses of therapeutic interventions. The benefits of screening for congenital hypothyroidism have been well documented and screening should be universally adopted for all neonates regardless of ethnic or geographical influences, not only for the inestimable benefits for the affected individuals, but also for the significantly decreased burden of disease and costs of long-term care.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

“…23,24,43 However this strategy has been questioned by several studies that have demonstrated that a high percentage of patients will be missed if screening is not universal. 50,51 Nonetheless neonatal TSH screening is a proven, cost-effective method that should be available to every newborn. The incidence (birth prevalence) of CH varies from country to country, but in most iodine replete populations it is usually between 1 in 3000 and 1 in 4000.…”

Section: Functional Thyroid Disordersmentioning

confidence: 99%

Screening for thyroid disease and iodine deficiency

Eastman

2012

Pathology

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“…In the pre-NBS era, as many as one-fourth of children with clinically diagnosed, overt CH developed mild-tomoderate intellectual disability and received special schooling (1). With NBS and timely and appropriate treatment, children with CH no longer require special education services, (68) although behavioral problems are sometimes reported (69).…”

Section: Economic Implicationsmentioning

confidence: 99%

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

Lain¹,

Trumpff²,

Grosse³

et al. 2018

ESPE

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When newborn screening (NBS) for congenital hypothyroidism (CH) using thyroid-stimulating hormone (TSH) as a primary screening test was introduced, typical TSH screening cutoffs were 20-50 U/L of whole blood. Over the years, lowering of TSH cutoffs has contributed to an increased prevalence of detected CH. However, a consensus on the benefit deriving from lowering TSH cutoffs at screening is lacking. The present paper outlines arguments both for and against the lowering of TSH cutoffs at NBS. It includes a review of recently published evidence from Australia, Belgium and Italy. A section focused on economic implications of lowering TSH cutoffs is also provided. One issue that bears further examination is the extent to which mild iodine deficiency at the population level might affect the association of neonatal TSH values with cognitive and developmental outcomes. A debate on TSH cutoffs provides the opportunity to reflect on how to make NBS for CH more effective and to guarantee optimum neurocognitive development and a good quality of life to babies with mild as well as with severe CH. All authors of this debate article agree on the need to establish optimal TSH cutoffs for screening programs in various settings and to ensure the benefits of screening and access to care for newborns worldwide.

show abstract

The Continuing Health Burden of Congenital Hypothyroidism in the Era of Neonatal Screening

Cited by 13 publications

References 20 publications

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

Screening for thyroid disease and iodine deficiency

Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?

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