土耳其新生儿先天性甲状腺功能减退症筛查结果--一个单一中心的经验。

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Journal of Pediatric Endocrinology & Metabolism Pub Date : 2024-11-14 DOI:10.1515/jpem-2024-0377
Ihsan Esen, Nilgun Eraslan, Deniz Okdemir
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引用次数: 0

摘要

目的旨在调查通过新生儿筛查转诊至土耳其一家三级医疗中心接受原发性先天性甲状腺功能减退症(CH)评估的婴儿的治疗效果:方法:回顾性审查了 2013 年 6 月至 2020 年 6 月期间通过新生儿筛查转诊的 328 名新生儿的医院档案。对新生儿入院时的临床特征、随访数据和最终诊断进行评估:16名新生儿(4.9%)在随访后被诊断为一过性新生儿高促性腺激素血症。在诊断为CH的病例中,有166例(50.6%)开始接受治疗。开始治疗的中位年龄为 17 天(5-69 天)。88.3%的病例在出生后的第一个月开始接受治疗。经过至少3年的随访,30/120(20.0%)的病例被诊断为永久性CH,11/30(36.7%)的病例被诊断为甲状腺发育不良。所有在 1 岁或 2 岁时每天使用超过 37.5 µg 左甲状腺素的病例在随访期间都被诊断为永久性甲状腺肿。对于一过性CH的预测,1岁时每天左甲状腺素剂量≤25微克的敏感性和特异性分别为96.2%和46.2%,2岁时的敏感性和特异性分别为97.8%和65.2%:在该队列中,10%的转诊病例会导致永久性CH。通过超声波进行甲状腺成像和随访期间的左甲状腺素剂量对预测永久性甲状腺肿具有指导意义。
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Outcomes of newborns screened for congenital hypothyroidism in Turkey - a single center experience.

Objectives: It was aimed to investigate the outcomes of babies referred to a tertiary health center in Turkey for evaluation primary congenital hypothyroidism (CH) through newborn screening.

Methods: The hospital files of 328 newborns who were referred for CH from newborn screening between June 2013 and June 2020 were retrospectively reviewed. The newborns were evaluated with their clinical characteristics at admission, as well as their follow-up data and final diagnoses.

Results: Sixteen (4.9 %) newborns were diagnosed with transient neonatal hyperthyrotropinemia after follow-up. Treatment was initiated in 166 (50.6 %) of the cases with a diagnosis of CH. The median age at initiation of treatment was 17 days (5-69). Treatment was initiated in 88.3 % of the cases in the first month of the life. After at least 3 years of follow-up, 30/120 (20.0 %) of the cases were diagnosed with permanent CH and 11/30 (36.7 %) of them were diagnosed with thyroid dysgenesis. All of the cases who used >37.5 µg per day levothyroxine at the age of 1 or 2 years were diagnosed with permanent CH during their follow-up. For the prediction of transient CH, the sensitivity and specificity of levothyroxine doses of ≤25 µg per day at 1 year of age were calculated as 96.2 and 46.2 %, and for 2 years of age, the sensitivity and specificity were calculated as 97.8 and 65.2 %.

Conclusions: In this cohort, 10 % of all referrals result in permanent CH. Thyroid imaging with ultrasonography and levothyroxine dose during follow-up can be guiding in predicting permanent CH.

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来源期刊
CiteScore
2.70
自引率
7.10%
发文量
176
审稿时长
3-6 weeks
期刊介绍: The aim of the Journal of Pediatric Endocrinology and Metabolism (JPEM) is to diffuse speedily new medical information by publishing clinical investigations in pediatric endocrinology and basic research from all over the world. JPEM is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups. JPEM is a high-quality journal dedicated to pediatric endocrinology in its broadest sense, which is needed at this time of rapid expansion of the field of endocrinology. JPEM publishes Reviews, Original Research, Case Reports, Short Communications and Letters to the Editor (including comments on published papers),. JPEM publishes supplements of proceedings and abstracts of pediatric endocrinology and diabetes society meetings.
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