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

par Delange, François ;Camus, Marguerite ;Winkler, Markus;Dodion, Josée;Ermans, André Marie
Référence Archives of Disease in Childhood, 52, 2, page (89-96)
Publication Publié, 1977

Article révisé par les pairs

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Résumé :

In 327 newborns cord blood thyroxine (T4) was 11.8 ± 0.4 μg/100 ml (SEM) 151.9 ± 5.1 nmol/l), and serum thyrotrophin (TSH) 6.7 ± μU/ml. μO/ml. Variability was marked for both T4 and TSH. Remeasured in the same patients on the fifth day of life, the TSH level was 3.7 ± 1.0 μU/ml, lower than at birth (P <0.001), while scattering of TSH values was much smaller, with 99.4% of the values <12 μU/ml. TSH level at day 5 was therefore subsequently used as a screening procedure, considering 12 μU/ml as the upper limit of normal. In 14 of 1805 newborns (0.8%), the TSH level exceeded this limit; in 3 raised TSH levels were subsequently confirmed, and hypothyroidism established by conventional criteria. One was a case of lingual thyroid (TSH >50 μU/ml) and the other 2 (TSH 27 and 50 μU/ml) iatrogenic caused by massive iodine impregnation of the mother (amniofetography). High TSH levels (160, 500, and 234 μU/ml) were also found in 3 hypothyroid infants aged less than one month who did not belong to the present screening programme. The striking difference between the TSH levels observed in normal and in hypothyroid infants during the first weeks of life suggests that serum TSH level at day 5 of life is the best parameter for systematic screening for congenital hypothyroidism.