Thyroid Development and Disorders of Thyroid Function in the Newborn

Fisher, Delbert A.; Klein, Alan H.

doi:10.1056/nejm198103193041205

Cited by 501 publications

(233 citation statements)

References 76 publications

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“…Os padrões de TSHneo estabelecidos em muitos programas são construídos com base na variação da idade da coleta do recém-nascido, de 2 a 7 dias com poucos dias para realização do ensaio. Na prática, os programas de triagem no Brasil executam a coleta do exame e o ensaio com prazos maiores, criando um problema metodológico para definir o padrão para essa nova realidade (4,5,(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). Sabe-se que há redução da média das concentrações do TSH nos primeiros dias de vida até sua estabilização (5), e amostras estocadas sofrem inativação com o tempo.…”

Section: Discussionunclassified

“…Sabe-se que há redução da média das concentrações do TSH nos primeiros dias de vida até sua estabilização (5), e amostras estocadas sofrem inativação com o tempo. Nossos dados mostram a redução das concentrações do TSHneo com o aumento da idade da criança na coleta, o que pode contribuir para pontos de corte menores quando o teste de triagem é colhido mais tarde (5,39). Existe a variação sazonal e circadiana que altera a concentração do TSH, mas no Nordeste do Brasil a temperatura é alta, a variação da temperatura ambiente é pequena e os exames em Sergipe são coletados pelo dia (5,27,47,48).…”

Section: Discussionunclassified

“…Nossos dados mostram a redução das concentrações do TSHneo com o aumento da idade da criança na coleta, o que pode contribuir para pontos de corte menores quando o teste de triagem é colhido mais tarde (5,39). Existe a variação sazonal e circadiana que altera a concentração do TSH, mas no Nordeste do Brasil a temperatura é alta, a variação da temperatura ambiente é pequena e os exames em Sergipe são coletados pelo dia (5,27,47,48). A terceira questão é a diversidade étnica que é confirmada pelas diferenças de incidência entre os povos (48,49).…”

Section: Discussionunclassified

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Programa de triagem neonatal para hipotireoidismo congênito no nordeste do Brasil: critérios diagnósticos e resultados

Ramalho

Oliveira

et al. 2008

Arq Bras Endocrinol Metab

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RESUMOAvaliamos as concentrações do TSH em papel-filtro colhido no calcanhar (TSHneo) de 48.039 crianças triadas do programa de triagem neonatal (PTN) para o hipotireoidismo congênito (HC) de Sergipe, as concentrações de TSH, T4 total e T4 livre colhidas em sangue periférico nas crianças convocadas suspeitas de HC, a idade nas diversas fases do programa, a cobertura e a freqüência do PTN de janeiro de 2005 a agosto de 2006, comparando-as com dados da literatura. Utilizamos para análise os seguintes parâmetros: média, mediana, coeficiente de variação e distribuição de freqüência. A idade da criança por ocasião da coleta em papel filtro no calcanhar foi 10 ± 9 dias (média ± desvio-padrão) e a idade na realização do ensaio do TSHneo foi de 31 ± 13 dias. Em 2005, a cobertura do PTN, para o interior e para a capital de Sergipe, foi de 77% e 73%, respectivamente. Verificamos que em 99,484% das crianças triadas as concentrações do TSH coletado em papel-filtro encontravam-se entre 0,01 e 5,20 µU/mL. As concentrações do TSH decrescem com o aumento da idade até estabilizar entre 11 e 15 dias de vida. ABSTRACT Neonatal Screening Program for Congenital Hypothyroidism in Northeast of Brazil: Criteria, Diagnosis and Results.It was evaluated the concentration of TSH in blood spot (TSHneo) of 48.039 children included in the Neonatal Screening Program (NSP) for Congenital Hypothyroidism (CH) of Sergipe (SE), a state in the northeast of Brazil. It was also evaluated the concentration of serum TSH, total T4 and free T4 in the recalled children suspicious of having CH, their age in several phases of the program, the covering and frequency of the NSP in the cases from January 2005 to August 2006, comparing them with literature data. The following parameters were used or the analysis: mean, standard deviation, median, coefficient of variation and frequency distribution. The children´s age at the collection in filter-paper specimen was 10 ± 9 days (Mean±SD) and the TSHneo execution assay was done in the period of 31 ± 13 days. In 2005 the covering by the NSP was about 77% in the countryside and 73% in Aracaju, the capital of Sergipe. It was verified that in 99,484% of the children included in the screening, the TSHneo varied from 0,01 to 5,20µU/ml, decreasing according to the age and stabilizing when they were between 11 and 15 days. 248 children were recalled from the TSHneo (1/194).The concentrations of TSH, T4 and free T4 collected by venous puncture were normal in 119 children (1/404). The frequency of suspected CH was 1/485 (99 cases), of CH was 1/6005 (8 cases) and of hypothyroxinemia was 1/16013 (3 cases). Therapy for CH began within 51 ± 12 days.

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Section: Discussionunclassified

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Programa de triagem neonatal para hipotireoidismo congênito no nordeste do Brasil: critérios diagnósticos e resultados

Ramalho

Oliveira

et al. 2008

Arq Bras Endocrinol Metab

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“…Fetal goitrous hypothyroidism is an uncommon condition reported to be associated with intrauterine exposure to goitrogens, congenital metabolic disorders of the thyroid system, and chronic iodine deficiency [6][7][8]. The class of goitrogens includes antithyroid drugs, iodine-containing vitamins, and iodine-rich products [9].…”

Section: Discussionmentioning

confidence: 99%

Successful Intrauterine Therapy for Fetal Goitrous Hypothyroidism during Late Gestation

et al. 2007

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Abstract. We experienced a case of fetal goitrous hypothyroidism in an infant delivered by a 33-year-old woman receiving 300 mg/day of propylthiouracil (PTU) for hyperthyroidism due to Graves' disease. A large fetal goiter (maximum diameter, 60 mm) was detected by magnetic resonance imaging (MRI) at 36 weeks of gestation. Initial fetal blood sampling revealed hypothyroidism with a serum thyroid-stimulating hormone (TSH) of 99 µIU/mL, free triiodothyronine (T 3 ) of 1.97 pg/mL, and free thyroxine (T 4 ) of 0.29 ng/dL. Consequently, a diagnosis of fetal goitrous hypothyroidism due to transplacental passage of maternal PTU was made. To reduce the risk of perinatal complications, 300 µg of levothyroxine sodium (L-T 4 ) was administered into the maternal amniotic fluid twice between 37 and 38 weeks of gestation. Subsequent fetal MRI showed that the size of goiter had decreased. At 38 weeks and 5 days of gestation, a 3042-g male infant was born by cesarean section. There were no severe complications at delivery, although mild tachypnea was observed and the infant's thyroid gland was slightly enlarged. He was treated with L-T 4 for two weeks. At present, his growth and neurological development are normal. This case indicates that intrauterine therapy by the intraamniotic administration of L-T 4 can be effective in treating fetal goitrous hypothyroidism even during late gestation.

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“…Congenital hypothyroidism is a well recognized disease causing mental and growth retardation and its etiology has been studied extensively (Fisher and Klein, 1981). A developmental defect of the thyroid termed "thyroid dysgenesis" includes thyroid aplasia , thyroid hypoplasia and ectopic thyroid is the most common cause of the disorder but its etiology has not yet been clarified.…”

Section: Introductionmentioning

confidence: 99%

An analysis of the variation of incidence of congenital dysgenetic hypothyroidism in various countries.

et al. 1984

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Thyroid Development and Disorders of Thyroid Function in the Newborn

Cited by 501 publications

References 76 publications

Programa de triagem neonatal para hipotireoidismo congênito no nordeste do Brasil: critérios diagnósticos e resultados

Programa de triagem neonatal para hipotireoidismo congênito no nordeste do Brasil: critérios diagnósticos e resultados

Successful Intrauterine Therapy for Fetal Goitrous Hypothyroidism during Late Gestation

An analysis of the variation of incidence of congenital dysgenetic hypothyroidism in various countries.

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