Abstract
Amaç: Konjenital hipotiroidi erken tanı ve tedavi ile önlenebilen mental motor geriliklerin en sık rastlanan sebebidir. Erken tanı ancak yenidoğan tarama testleri ile mümkündür. Bu çalışmada, tarama testinin uygulanmadığı dönemde, hastanemize başvuran yenidoğanlarda bakılan tiroid fonksiyon testlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmaya Ocak 2003 Mart 2006 tarihleri arasında hastanemizde doğan veya hastanemize herhangi bir nedenle başvuran yenidoğanlar dahil edildi. Dosyalarından annelere ve bebeğe ait bilgiler, fizik inceleme bulguları, tiroid fonksiyon testlerinin sonuçları, konjenital hipotiroidili olguların etyolojiye yönelik incelemeleri ve izlemleri sırasında yapılan değerlendirmeleri kaydedildi.Bulgular: Toplam 139 olgunun (72 kız -77 erkek) tiroid fonksiyon testleri değerlendirildi. Başvuru nedenleri 95 olguda (% 68.3) kontrol amaçlı, 44 olguda (% 31.7) ise sarılık idi. Olguların tiroid fonksiyon testlerinin alınma zamanı 4 ile 45 gün arasında değişiyordu. Yedi olguda serum TSH düzeyi 20 IU/L'nin üzerinde, bir olguda ise normal iken, serum Total T4 düzeyi düşük idi. Bu olgulardan üçü konjenital hipotirodi tanısı aldı. Nedene yönelik değerlendirmede bir olguda santral hipotiroidi, bir olguda ektopik tiroid saptanırken, tiroid ultrasonografisi ve sintigrafisi normal olan son olguda etyoloji aydınlatılamadı.Sonuç: Tarama programı öncesinde yapılmış olan bu çalışmada olguların % 2.1'inde konjenital hipotiridizm saptandı. Bu çalışma, tarama programı olmaması nedeniyle konjenital hipotiroidi insidansı hakkında bilgi vermemekle birlikte yenidoğan tarama programının önemini vurgulamaktadır.
References
- Yordam N, Çalıkoğlu A, Hatun Ş, Kandemir N, Oğuz H, Teziç T, Ö- zalp İ. Yenidoğan Dönemi Konjenital Hipotiroidizm Tarama Prog- ramı Pilot Çalışması. Çocuk Sağlığı ve Hastalıkları Dergisi. 1994;37: 235.
- Vulsma T, Gons MH, de Vijlder JJ. Maternalfetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or Thyroid agenesis. N Eng J Med. 1989;321:13-16.
- Huang SA, Dorfman DM, Genest DR, Salvatore D, Larsen PR. Type iodothyronine deiodinase is highly expressed in the human utero- American Academy of Pediatrics AAP Section on Endocrinology and Committee on Genetics, and American Thyroid Association Committee on Public Health: Newborn Screening for Congenital Hypothyroidism: recommended guidelines. Pediatrics. 1993;91:1203
- Dussault JH, Coulombe P, Laberge C, Letarte J, Guyda H, Khoury K. Preliminary report on a mass screening program for neonatal Hypothyroidism. J Pediatr. 1975;86:670-674.
- Ataş A, Çakmak A, Karazeybek H. Konjenital Hipotiroidizm. Güncel Pediatri 2007;5:70-76.
- Law WY, Bradley DM, Lazarus JH, John R, Gregory JW. Congenital Glorieux J, Dussault J, Van Vielt G. Intellectual development at age years of children with congenital hypothyroidisim diagnosed by Gönç N, Yordam N. Çocukluk ve adölesanda tiroid hastalıkları.In: Günöz H, Öcal G, Yordam N, Kurtoğlu S editors:Pediatrik Endokri- neonatal screening. J Pediatr. 1992;121:581-584. noloji. 1. Baskı, Ankara: Kalkan Mat. 2003; 261-360.
- American Academy of Pediatrics, Rose SR; Section on Endorinology and Committee on Genetics, American Thyroid Association, Brow Fisher DA. Disorder of the thyroid in the newborn and infant. In S- perling MA (ed). Pediatric Endocrinology. 2 rd ed. Philadelphia: Saun- RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine ders. 2002:161-209.
Abstract
Aim: Congenital hypothyroidism is the most frequent reason of preventable mental-motor retardation if early diagnosed and treated. Early diagnosis can only be insured by neonatal screening programs. In this study we aimed to evaluate thyroid function tests in newborns who admitted to hospital before screening test was done routinely.Method: The neonates born in or admitted to our hospital with any reason between January 2003-March 2006, were enrolled in this study. Maternal and neonatal data, physical findings of the newborns, the resuls of the thyroid function tests, etiologic investigation of the patients with congenital hypothyroidism were recorded.Results: In 139 neonates (72 femele - 77 male) thyroid function tests were evaluated. Admission reasons were hyperbilirubinemia in 44 (31.7 %) and routine control in 95 (68.3 %) patients. Thyroid function tests had been measured between 4 to 45 postnatal days. Serum TSH levels were higher than 20 IU/L in 7 neonates, whereas in one, serum TSH level was in normal limits and serum Total T4 was low. Among these, 3 patients were diagnosed as congenital hypothyroidism. Etiological evaluation revealed central hypothyroidism and ectopic thyroid in two patients. In one patient etiology couldn't be clarified since his thyroid ultrasonography and scintigraphy were normal. Conclusion: In this study that has been performed before screening program congenital hypothyroidism was detected in 2.l % of the patients. Although it is not a screening program and can not provide information about the incidence of congenital hypothyroidism, this study highlights the importance of neonatal screening
References
- Yordam N, Çalıkoğlu A, Hatun Ş, Kandemir N, Oğuz H, Teziç T, Ö- zalp İ. Yenidoğan Dönemi Konjenital Hipotiroidizm Tarama Prog- ramı Pilot Çalışması. Çocuk Sağlığı ve Hastalıkları Dergisi. 1994;37: 235.
- Vulsma T, Gons MH, de Vijlder JJ. Maternalfetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or Thyroid agenesis. N Eng J Med. 1989;321:13-16.
- Huang SA, Dorfman DM, Genest DR, Salvatore D, Larsen PR. Type iodothyronine deiodinase is highly expressed in the human utero- American Academy of Pediatrics AAP Section on Endocrinology and Committee on Genetics, and American Thyroid Association Committee on Public Health: Newborn Screening for Congenital Hypothyroidism: recommended guidelines. Pediatrics. 1993;91:1203
- Dussault JH, Coulombe P, Laberge C, Letarte J, Guyda H, Khoury K. Preliminary report on a mass screening program for neonatal Hypothyroidism. J Pediatr. 1975;86:670-674.
- Ataş A, Çakmak A, Karazeybek H. Konjenital Hipotiroidizm. Güncel Pediatri 2007;5:70-76.
- Law WY, Bradley DM, Lazarus JH, John R, Gregory JW. Congenital Glorieux J, Dussault J, Van Vielt G. Intellectual development at age years of children with congenital hypothyroidisim diagnosed by Gönç N, Yordam N. Çocukluk ve adölesanda tiroid hastalıkları.In: Günöz H, Öcal G, Yordam N, Kurtoğlu S editors:Pediatrik Endokri- neonatal screening. J Pediatr. 1992;121:581-584. noloji. 1. Baskı, Ankara: Kalkan Mat. 2003; 261-360.
- American Academy of Pediatrics, Rose SR; Section on Endorinology and Committee on Genetics, American Thyroid Association, Brow Fisher DA. Disorder of the thyroid in the newborn and infant. In S- perling MA (ed). Pediatric Endocrinology. 2 rd ed. Philadelphia: Saun- RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine ders. 2002:161-209.
Details
| Other ID | JA67UD89PU |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 1, 2008 |
| Submission Date | June 1, 2008 |
| Published in Issue | Year 2008 Volume: 2 Issue: 2 |
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The publication language of Turkish Journal of Pediatric Disease is English.
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