Abstract
Transient neonatal hyperthyrotropinemia (TNH) is a rare condition that must be included in the differential diagnosis of congenital hypothyroidism (CH) to avoid inappropiate thyroid hormone replacement. Our screening program for congenital hypothyroidism evaluated 4,075 newborns with simultaneous determinations of TSH and T4 in the umbilical cord blood after immediate clamping. Newborns presenting TSH concentrarions higher than 40 uU/ml (n= 38; 0.7%) were recalled. In this group, 9 out of them (0.2%) had TSH values above 60 uU/ml. All 38 newborns presented normal T4 levels and their TSH values were observed to fall within the normal range (1-7 uU/ml) between the 6th and the 30th week after delivery. TNH was associated to fetal or maternal stress. Fetal stress causes were anoxia (39%), jaundice (37%)> birth injury (24%), prematurity (16%), respiratory distress syndrome (10%), hemolytic disease (5%) and congenital anomalies (5%). Maternal causes were hypertensive disease (10%), premature separation of placenta (5%), eclampsia (5%) premature amniorrhexis (2.6%) and diabetes mellitus (2.6%). We concluded that 1) the frequency of TNH is higher in our population than the one observed in other studies. 2) the cutoff point for isolated TSH determination should be higher than the one usually utilized and 3) simultaneous TSH and T4 determinations should be employed in the screening programs for congenital hypothyroidism.
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Sgarbi, J., Novaes, M., Biancalana, M. et al. TRANSIENT NEONATAL HYPERTHYROTHROPINEMIA. Pediatr Res 28, 421 (1990). https://doi.org/10.1203/00006450-199010000-00034
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DOI: https://doi.org/10.1203/00006450-199010000-00034