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Utility of the New Indian Society of Paediatric and Adolescent Endocrinology (ISPAE) Guidelines for Congenital Hypothyroidism Screening in a High Risk Unit

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A Correction to this article was published on 17 September 2021

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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%), 16 (19.2%) and 31 (37.3%) cases had screening TSH >20 μIU/mL, 6-20 μIU/mL and < 6 μIU/mL, respectively. Out of the 47 babies with screening TSH <20 μIU/mL, 23 (48.9%), 25 (53.1%) and 12 (25.5%) cases had prematurity, maternal thyroid disease and illness, respectively, as risk factors (some babies had more than one risk factor). Of the 83 cases, all of them had venous TSH >10 μIU/mL and five cases had low Free T4 (<1.1 ng/dl). Thus, none of the cases with congenital hypothyroidism were missed on the new ISPAE guidelines.

Conclusion

The new ISPAE guidelines for neonatal screening for congenital hypothyroidism are very useful and applicable in Indian neonates.

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Acknowledgements

The authors acknowledge Prof. Nedunchelian Krishnamoorthy, Department of Research, Mehta Multispeciality Hospitals India Pvt. Ltd., for reviewing this manuscript.

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Authors and Affiliations

  1. Department of Neonatology, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India

    Lakshmi Venugopalan, Gnanabalan Murugesan & R. Shanmughasundaram

  2. Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India

    Sugapriya Paranjyothi & Anupama Sankaran

  3. Department of Pediatric Endocrinology and Diabetes, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India

    Hemchand Krishna Prasad

Authors
  1. Lakshmi Venugopalan
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  2. Sugapriya Paranjyothi
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  3. Anupama Sankaran
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  4. Hemchand Krishna Prasad
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  5. Gnanabalan Murugesan
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  6. R. Shanmughasundaram
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Contributions

SP and AS were clinicians involved in data collection. HKP, LV, GM and RS were clinicians involved in the care of the subjects. All authors contributed to the manuscript. HKP shall act as a guarantor of the study and be the corresponding author.

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Correspondence to Hemchand Krishna Prasad.

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The original version of the article was revised: The statement: “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. should read as the follows: Out of the 83 cases, 36 (43.3%), 16 (19.2%) and 31 (37.3%) cases had screening TSH >20 μIU/mL, 6-20 μIU/mL and < 6 μIU/mL, respectively.

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Venugopalan, L., Paranjyothi, S., Sankaran, A. et al. Utility of the New Indian Society of Paediatric and Adolescent Endocrinology (ISPAE) Guidelines for Congenital Hypothyroidism Screening in a High Risk Unit. Indian J Pediatr 88, 1075–1079 (2021). https://doi.org/10.1007/s12098-020-03555-x

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  • DOI: https://doi.org/10.1007/s12098-020-03555-x

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