Early diagnosis for congenital hypothyroidism
clinical practice challenge in face of a normal neonatal screening test
Keywords:
Growth and development, Congenital hypothyroidism, Mental retardation, Neonatal screeningAbstract
The screening of newborn babies for congenital hypothyroidism has changed the
natural history of this disease. which, if not treated early, leads to permanent stunting
and/or impaired development, We describe the case of a male child with congenítal
hypothyroidism not detected by neonatal screening (collected 6 days after birth) and
only diagnosed during the second semester of life, despite having shown clinical
signs. A newbom screening normal for congenital hypothyroidism does not preclude
the development of the disease. Clinical follow-up must be maíntained and new
exams (T4 and TSH determinations) requested when suggestive symptoms appear in
order to avoid irreversible damages.
Downloads
References
Therrel BL, Adams J. Newborn screening in North America. J Inherit Metab Dis. 2007; 30(4):447-65.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Manual de normas técnicas e rotinas operacionais do programa nacional de triagem neonatal. 2a. ed. Ampliada. Brasília; 2004. [acesso 2008 dez. 22]. Disponível em: http://dtr200 1 .saude.gov. br/editora/produtos/livros/pdf/04_0808_M1.pdf
Souza CFM, Schwartz IV, Giugliani R. Triagem neonatal de distúrbios metabólicos. Ciênc Saúde Coletiva 2002; 7(1):129-37.
American Academy of Pediatrics, Rose SR, Section on Endocrinology and Committee on Genetics, American Association, Brown RS, Public Health Committee, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006; 117(6):2290-303.
Marini de Carvalho T, Pimentel dos Santos H. dos Santos ICGR Vargas PR, Pedrosa J. Newborn screening: a national public health programme in Brazil. J Inherit Metab Dis. 2007; 30(4):615.
Desposito F, Lloyd-Puryear MA, Tonniges TF, Rhein F, Mann M. Survey of pediatrician practices in retrieving statewide authorized newborn screening results Pediatrics. 2001; 108(2):E22; e22.
Yunis KA. Nasr MR, Lepejian G, Najjar S, Daher R False-negative primary neonatal thyroid screening: the need for clinical vigilance and secondary screening. J Med Screen. 2003; 10(1):2-4.
American Academy of Pediatrics, Newborn Screening Task Force. Serving the family from birth to the medical home: newborn screening a blueprint for the future Pediatrics. 2000; 106(2):389-427.
American Academy of Pediatrics. Section on Endocrinology and Committee on Genetics. Newborn screening for congenital hypothyroidism recommended guidelines. Pediatrics. 1993; 91 (6):1203-9.
Ward LS, Maciel RMB, Magalhães RF, Kunii IS, Kurazawa GK, Matsumura LK, et al. Comparação de duas estratégias para a detecção precoce do hipotiroidismo congênito. Rev Ass Med Bras. 1998; 44(2):81-6.