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Diagnosis and treatment of subclinical hypothyroidism detected by neonatal screening

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Abstract

Background

This study was undertaken to explore the clinical outcome and prognosis of subclinical hypothyroidism detected by newborn screening.

Methods

Newborn screening was conducted at 1156 health care institutions in Zhejiang Province from October 1999 to September 2006. Included were (1) infants who had thyroid-stimulating hormone (TSH) ≥20 mU/L, and normal or lower normal levels of triiodothyronine (T3) and thyroxine (T4) and (2) infants with TSH between 5.6 mU/L and 20 mU/L at a confirmatory examination and follow-up showing TSH levels ≥20 mU/L or delayed reduction in T4 levels. These infants were considered as having subclinical hypothyroidism and levothyroxine (L-T4) at an initial dose of 3–5 μg/kg per day was administered. The levels of TSH and T4, developmental quotient (DQ), and index of growth were evaluated.

Results

A total of 204 infants met our criteria for subclinical hypothyroidism, with an incidence of 1/8809. After 2–4 weeks of standard therapy, serum TSH level dropped to normal and T4 reached a higher normal level in all the 204 infants. Evaluations of 60 patients after 2 years of therapy showed that their average DQ was 101±14.61, and body weight and height were within the normal ranges. Bone age test for 54 patients revealed normal development in 44, slightly retarded development in 7, and advanced development in 3.

Conclusions

Newborns with high TSH levels should be given particular attention to ensure early diagnosis. A L-T4 dose of 3–5 μg/kg per day was effective in the initial treatment of subclinical hypothyroidism.

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Authors and Affiliations

  1. Department of Genetics and Metabolism, Zhejiang University School of Medicine, Hangzhou, China

    Xiao-Xiao Chen, Xue-Lian Zhou, Ru-Lai Yang, Yu-Hua Shi, Hua-Qing Mao, Yi-Ping Qu & Xu Wang

  2. Department of Preventive Medicine and Child Health Care, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Yu-Feng Qin & Zheng-Yan Zhao

  3. Department of Preventive Medicine and Child Health Care, Children’s Hospital, Zhejiang University School of Medicine, 57 Zhu Gan Xiang, Hangzhou, 310003, China

    Zheng-Yan Zhao

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  1. Xiao-Xiao Chen
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  2. Yu-Feng Qin
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  3. Xue-Lian Zhou
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Correspondence to Zheng-Yan Zhao.

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Chen, XX., Qin, YF., Zhou, XL. et al. Diagnosis and treatment of subclinical hypothyroidism detected by neonatal screening. World J Pediatr 7, 350–354 (2011). https://doi.org/10.1007/s12519-011-0314-4

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  • DOI: https://doi.org/10.1007/s12519-011-0314-4

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