Abstracts of the Poster Sessions
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 testl. 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.
KeywordsIodine Deficiency Thyroid Dysfunction Recall Rate Congenital Hypothyroidism Neonatal Screening
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