Abstract
Data collected in Zaire suggested that severe iodine deficiency resulted in neonatal hypothyroidism and its longterm consequence, endemic cretinism. In order to further evaluate this possibility, we initiated neonatal thyroid screening in an endemic goiter area in Algeria (area A) with a high prevalence of goiter (51.3 %) and cretinism (1.1 %) and a low dietary supply of iodine (I) (Mean urinary I : 16.2 μg/g creatinine) and in a non goitrous area (B) with no cretinism and a normal iodine supply (urinary 1:73.9 μg/g creat.). Serum TSH levels in 3135 newborn infants of area A were shifted towards high values as compared to the results obtained in area B (n=3136). Consequently, for a similar cut-off point for TSH of 40 μU/ml serum, the recall rate was higher in area A (14/3135=0.45 %) than in area B (1/3136 = 0.03 %). The control examinations in the 15 infants recalled were normal in 8 but confirmed severe hypothyroidism in the last 7 infants, all from area A (mean serum TSH:187 μU/ml, T4:2.7 μg/dl). They were put on T4 therapy. Follow up and reevaluation of the diagnosis at the age of 18 months (5/7 infants) including thyroid scintigrams and withdrawal of therapy evidenced thyroids in normal position in the 5 infants, transient hypothyroidism in 3 and persistent hypo.in the last 2 infants. In conclusion, the incidence of neonatal hypothyroidism is elevated in endemic goiter in Algeria (1/450 newborns). Hypothyroidism is transient in most infants but possibly permanent in others. This situation could explain the presence of mental retardation and cretinism observed in adults in endemic goiter in Algeria.
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Chaouki, M., Delange, F., Maoui, R. et al. 65 NEONATAL HYPOTHYROIDISM IN ENDEMIC GOITER IN ALGERIA. Pediatr Res 19, 614 (1985). https://doi.org/10.1203/00006450-198506000-00085
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DOI: https://doi.org/10.1203/00006450-198506000-00085