Utility of the New Indian Society of Paediatric and Adolescent Endocrinology (ISPAE) Guidelines for Congenital Hypothyro
- PDF / 258,017 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 57 Downloads / 216 Views
ORIGINAL ARTICLE
Utility of the New Indian Society of Paediatric and Adolescent Endocrinology (ISPAE) Guidelines for Congenital Hypothyroidism Screening in a High Risk Unit Lakshmi Venugopalan 1 & Sugapriya Paranjyothi 2 & Anupama Sankaran 2 & Hemchand Krishna Prasad 3 Gnanabalan Murugesan 1 & R. Shanmughasundaram 1
&
Received: 11 June 2020 / Accepted: 22 October 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Objective To study the new ISPAE guidelines in neonates with congenital hypothyroidism and present authors’ experience in managing these neonates. Methods A retrospective review of all babies who were screened for congenital hypothyroidism in the institution over a period of 5 y was conducted. Details pertaining to maternal risk factors, neonatal risk factors, screening TSH, venous TSH and details of etiological evaluation including: ultrasound thyroid, technetium 99m scintigraphy and anti thyroid peroxidase antibody estimation were retrieved. The cases were assessed using the new ISPAE guidelines. Results During the study period, 8107 babies were screened for congenital hypothyroidism, 83 cases had confirmed disease and 47 had established etiology. There is a fair correlation between screening TSH and venous TSH (r = 0.7, p < 0.05). The estimated incidence of congenital hypothyroidism in present series is 1 in 97 cases. Out of the 83 cases, 36 (43.3%), 26 (31.3%) and 21 (25.3%) cases had screening TSH >20 μIU/mL, 6–20 μIU/mL and < 6 μIU/mL, respectively. Out of the 47 babies with screening TSH 10 μIU/mL and five cases had low Free T4 ( 6 μIU/mL was considered as positive [2]. Venous test was performed on all neonates who were screen positive, sick babies, preterm babies (60 IU/mL). Subjects with positive antibody were considered as transient hypothyroidism due to maternal antibody. Confirmed positives include those with venous TSH > 10 μIU/mL, with or without abnormality of the thyroid gland on technetium scintigraphy and ultrasound or elevated thyroid peroxidase antibody. The study was approved by the Institutional Ethics Committee. Data was entered in excel sheet and analysed using SPSS statistical software. Descriptive statistics in the form of proportions (percentages) and mean ± standard deviation were arrived. Pearsons correlation was used to determine correlation between screening and venous TSH and p value 3 d
34.5 ± 2.7 1.2:1
NICU Neonatal intensive care unit
31% 18% 18% 29.3% 70.7% 38.3% 60.8% 0.9% 9.2% 47% 8.5%
Indian J Pediatr
maternal thyroid disease). Amongst the 63 screen positive babies, 52 babies were confirmed to have congenital hypothyroidism on the basis of venous test. Among the 1622 repeat venous tests in initially screen negative babies, 31 were confirmed to have congenital hypothyroidism. Thus, a total of 83 babies were confirmed as congenital hypothyroidism in the study period, based on either an elevated venous TSH in all 83 cases and low Free T4 (20 μIU/mL, 6-20 μIU/mL and < 6 μIU/mL, respectively. Out of the 47 babies with screening TSH 10 μIU/mL and five cases had low
Data Loading...
