Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

Glorieux, Jacqueline; Desjardins, Michèle; Letarte, Jacques; Morissette, Jean; Dussault, Jean H.

doi:10.1203/00006450-198807000-00003

Cited by 95 publications

(47 citation statements)

References 4 publications

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“…A terceira questão é a diversidade étnica que é confirmada pelas diferenças de incidência entre os povos (48,49). A quarta é a diversidade ambiental e cultural influindo na concentração de iodo ingerido na alimentação (14,33,49,50). Existem diferenças nas concentrações do TSH e do T4 neonatal relativas às taxas de iodo do solo que influenciam nas taxas de iodo alimentar como também os programas de adição do iodo ao sal de cozinha (51-56).…”

Section: Discussionunclassified

“…A introdução dos programas de triagem neonatal representa importante instrumento de prevenção de retardo mental com adequada e tempestiva terapia substitutiva com L-tiroxina para os casos de HC, propiciando o desenvolvimento neuropsíquico da criança e de critérios para sua classificação (4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) Utilizamos os seguintes procedimentos: quantificou-se o número de crianças triadas na capital e no interior e calculou-se a média aritmética, mediana, o percentual e o desvio-padrão das idades das crianças triadas e das concentrações do TSH coletados em papel-filtro (tipo SS 903). O sangue foi colhido com lanceta do calcanhar das crianças, após o nascimento, e o TSH neonatal (TSHneo) foi dosado pelo método imunofluorimétrico da PerkinElmer Life and Analytical Sciences, Wallac, Turku, Finland.…”

Section: Introductionunclassified

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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

Section: Introductionunclassified

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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“…The same limit had previously been adopted by Heyerdahl et al (15). A knee epiphysis diameter , 3 mm implies that the epiphyseal area is , 0.07 mm 2 , which is very similar to the cut-off value (epiphyseal area , 0.05 mm 2 ) used by Glorieux et al (10). The patients with retarded BM were further divided into two subgroups: those with absent distal femoral nucleus (subgroup B1) and those with a small nucleus, i.e.…”

Section: Methodsmentioning

confidence: 99%

In congenital hypothyroidism bone maturation at birth may be a predictive factor of psychomotor development during the first Year of life irrespective of other variables related to treatment

Waśniewska

Luca

Cassio

et al. 2003

European Journal of Endocrinology

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Objective: To evaluate in a cohort of infants with congenital hypothyroidism (CH): (a) the frequency of bone maturation (BM) retardation at birth and (b) whether BM delay at birth may be considered as a tool to make a prognosis of psychomotor status at the age of 1 year, irrespective of other variables related to treatment. Design: BM at birth, CH severity and developmental quotient (DQ) at the age of 1 year were retrospectively evaluated in 192 CH infants selected by the following inclusion criteria: (a) gestation age ranging between 38 and 42 weeks; (b) onset of therapy within the first month of life; (c) initial thyroxine (L-T 4 ) dosage ranging from 10 to 12 mg/kg/day; (d) normalization of serum thyrotropin (TSH) levels before the age of 3 months; (e) monthly adjustments of L-T 4 dose during the first year of life with serum TSH levels ranging from 0.5 to 4 mIU/l; (f) no major diseases and/or physical handicaps associated with CH; (g) availability of both thyroid scanning and knee X-rays at the time of treatment initiation; (h) availability of DQ assessment at an average age of 12 months. Methods: BM was considered normal if the distal femur bony nucleus diameter exceeded 3 mm (group A) or retarded if either this nucleus was absent (subgroup B1) or its diameter was , 3 mm (subgroup B2). DQ was evaluated with the Brunet -Lézine test. Results: In 44.3% of cases BM was either delayed (23.5%) or severely delayed (20.8%). The risk of BM retardation was higher in the patients with athyreosis than in the remaining patients (41/57 vs 44/135, x 2 ¼ 25.13, P , 0.005). BM-retarded infants showed a more severe biochemical picture of CH at birth and a lower DQ at the age of one year compared with the group A patients. If compared with infants of subgroup B2 those of subgroup B1 exhibited significantly lower T 4 levels at birth and a more frequent association with athyreosis (70.0 vs 30.0%; x 2 ¼ 7.49, P , 0.01), whereas DQ was superimposable in both subgroups. Conclusions: (a) BM at birth is delayed in almost half of CH patients and (b) CH severity per se can affect DQ at the age of 1 year irrespective of other variables related to therapy.

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“…Atualmente, o tratamento do HC é considerado tempestivo quando iniciado até 14 dias de idade Triagem Neonatal: HC e PKU Ramalho et al e tardio maior que 30 dias, e deve obedecer ao padrão de 3 a 7 dias para a idade na coleta do teste de triagem neonatal para o HC, em conjunto com a da fenilcetonúria, segundo Portaria nº 822/2001 do Ministério da Saúde (1,10,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

Section: Discussionunclassified

Evolução do programa de triagem neonatal para o hipotireoidismo congênito e fenilcetonúria no Estado de Sergipe de 1995 a 2003

Ramalho

Oliveira

et al. 2004

Arq Bras Endocrinol Metab

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Useful Parameters To Predict the Eventual Mental Outcome of Hypothyroid Children

Cited by 95 publications

References 4 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

In congenital hypothyroidism bone maturation at birth may be a predictive factor of psychomotor development during the first Year of life irrespective of other variables related to treatment

Evolução do programa de triagem neonatal para o hipotireoidismo congênito e fenilcetonúria no Estado de Sergipe de 1995 a 2003

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