Abstract
Among 723,797 infants screened by both TSH and T4 in Kanagawa prefecture,Chiba prefecture and Sapporo city(for 4, 6 and 5 yr. respectively),106 infants with hypothyroidism have been detected (1/6,828). Of 106 cases, 16 were transient hypothyroidism(1/45,237), 89 were primary hypothyroidism(1/8,133),and only one was congenital selective pituitary TSH deficiency. Filter-paper spot TSH and T4 was measured by RIA. Cut off point of T4 level was mean-2SD in one assay system(usually between 3.5 and 4.5 mcg/dl, equivalent to serum) and TSH level was the highest 3% of one assay system(usually about 12 - 15mcU/ml,equivalent to whole blood). Only 5 of 106 cases(4.7%) were detected by low T4 value with normal TSH. One of them was selective TSH deficiency and the other 4 were transient hypothyroidism. The other 101 cases(95.3% of 106 cases ) were detected by high TSH with low T4(58 cases,54.7% of 106 cases) or without low T4(43 cases,40.6 %). The case with selective TSH deficiency, which showed hypothyroid symptoms on age 22 days,and reserved normal pituitary functions except TSH secretion and responsive thyroid gland to external TSH, will be presented. From these our study of ideal screening program, it is concluded that secondary or tertialy hypothyroidism is very rare in Japan, and primary TSH screening is superior to T4 screening program.
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Suwa, S., Nakajima, H., Matuupa, N. et al. 76 PRIMARY NEONATAL THYROID SCREENING BY BOTH TSH AND T4: RESULTS OF SCREENING 720,000 INFANTS IN JAPAN. Pediatr Res 19, 616 (1985). https://doi.org/10.1203/00006450-198506000-00096
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DOI: https://doi.org/10.1203/00006450-198506000-00096