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The Correlation Between the TSH Level in Neonatal Screening Test and the Prognosis of Congenital Hypothyroidism

Journal of the Korean Pediatric Society 2001;44(1):25-31.
Published online January 15, 2001.
The Correlation Between the TSH Level in Neonatal Screening Test and the Prognosis of Congenital Hypothyroidism
Hong Sun Park, Kye Shik Shim, Kyuchul Choeh
Department of Pediatrics, Eulji University School of Medicine, Taejon, Korea
신생아 선별검사의 TSH치와 선천성 갑상선 기능저하증의 예후와의 연관성
박홍선, 심계식, 최규철
을지의과대학교 소아과학교실
Abstract
Purpose
: It is important to diagnose and treat newborn patients with congenital hypothyroidism as soon as possible because of neurodevelopmental outcome. If we can detect more severe forms of congenital hypothyroidism with neonatal screening test, the results of treatment will improve.
Methods
: Sixty-four term infants whose TSH levels in neonatal screening test had been higher than 20μIU were recalled. Their serum levels of T3, T4, TSH and thyroid scans were checked. They were divided into two groups according to the results, in which T group had transient thyroid disease and P group had permanent congenital hypothyroidism. The TSH levels in neonatal screening test between the two groups were compared and correlated with T3, T4 and TSH levels in their serum.
Results
: The number of patients of T and P groups were 43 and 13 respectively. The mean TSH level of both group in neonatal screening test was 28.6μIU/mL and 55.7μIU/mL respectively. The mean TSH level in neonatal screening test is significantly higher in P than T group(P<0.05). If we choose 48μIU/mL as a cutoff value, the sensitivity of detecting the P group is 77% and the specificity is 100%. The TSH levels in neonatal screening test had a positive correlation with the serum TSH levels and a negative correlation with the serum T4 levels(r=0.56 P<0.01, r=-0.53 P<0.01).
Conclusion
: If the TSH level in neonatal screening test is greater than 48μIU/mL, there is a greater possibility of the permanent and severe congenital hypothyroidism. So we should try to diagnose and treat them more quickly.
Key Words: TSH, Prognosis, Congenital hypothyroidism


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