بررسي غربالگري كم كاري مادر زادي تيروييد در شهر كاشان سال 82-1381

Screening for congenital hypothyroidism in Kashan, Iran

Background and purpose : Congenital Hypothyroidism (CH) is one of the preventable causes of mental retardation, which according to its clinical manifestations within the neonatal perioid, can be diagnosed in only fewer than 10% of cases. Delayed diagnosis results in irreversible cerebro-auditory complications unless the problem is diagnosed by screening programs. Materials and methods : From May to December 2003, serum T4 and TSH concentrations of 3005 newborns on the 3rd - 7th day of their birth were measured by RIA and IRMA, respectively in all Kashan hospitals. The newborns with abnormal screening results were reexamined (TSH> 20 mIU/L, T4<6.5 .tg/dl and based on the weight). Newborns with TSH >10 mIU/L and T4<6.5 .tg/dl on the second measurment were considered to be hypothyroid. After performing complementary tests, replacement therapy with levothyroxine was begun in neonates with CH. Results : From 3005 neonates, 51 newborn were recalled (recall rate = 1.7%) and 10 newborns were diagnosed as hypothyroid cases. The prevalence of neonatal hypothyroidism was estimated to be 1 / 303. Conclusion : Considering the high prevalence of CH in the population, the necessity of routine neonatal screening programs is emphasized.