Abstracts of the Poster Sessions

Abstract

We performe TSH dry-spot screening as “Central CH-Screening for SH” since 1980. It covers 99,3% of all newborns in this area, the remaining are screened by more than 5 other laboratories. We follow up all cases of CH detected by our screening, either in our department or in collaboration with a local pediatrician. Since January 1980 we screened 95,657 out of 193,854 newborrsin this area. There were 879 recalls for serum with a declining recall rate from 2.23% in 1980 to 0.11% in 1987. Therapy and clinical follow-up was begun in 65 cases, of whom 30 were later considered transient hypothyroidism, 24 of them iodine-induced. Additional 4 children had transient, 2 so far permanent hypothyrotropinemia. The remaining 30 children are still under therapy (L-T₄), therefore incidence of CH in our population is 1:3188. We saw seasonal variation in CH-incidence: 15 children were born between Jan. and April, 7 in Sept. and Oct. At about 2 years of age we reevaluate thyroid-function after disruption of T₄ substitution, including scintigraphic scan, and intellectual and psychomotor developmental testing. Start of therapy in our patients was at day 6-33 (mean 13.3). Clinical follow-up of the children depicts insufficient L-Thyroxin substitution at one or more occasions in 80%. So far scintigraphic scan during follow-up showed 9 cases with athyreosis, 6 with ectopic thyroid tissue, and 3 with dyshormonogenesis. At age 2-4 mild deficiencies in intellectuel and psychomotor development could be demonstrated as a general trend in our patients, expressed as retardation in performance at or below the 90% level in a standardized test^l. Severe retardation in 6 children (28%) as well as the milder forms was focussed on speech, perception, and less pronounced on fine motor abilities. Retardation showed no other correlation then with social status and severe additional illness.