ESPE2016 Poster Presentations Thyroid P1 (48 abstracts)
Newborn Screening Program for Congenital Hypothyroidism: Eighteen Years of Experience in Buenos Aires Province, Argentina
Verónica González a , Mariela Espósito a , Laura Vitale a , Analia Morin a , Victoria Fasano a , Jorgelina Pattin a , Ferrari Celia a , Dietz Mariela b , Borrajo Gustavo b , Santucci Zulma a & Balbi Viviana a
aSSM Ludovica, La Plata, Argentina; bFundación Bioquímica Argentina, La Plata, Argentina
Background: Newborn (NB) screening programs show a wide variation in congenital hypothyroidism (CH) incidence along the years.
Objective and hypotheses: To describe CH incidence, etiology, associated malformations and Down Syndrome (DS) in children detected by our NB Screening Program. To search differences between permanent CH (PCH) and transient forms (TCH).
Method: We analyzed NB with positive screening results referred between April 1995 and December 2013. Two periods were analyzed: 1995–2004 (P1) and 2005–2013 (P2).CH was confirmed with TSH≥25 uUI/ml and T4<10 μg/dl. Incidence, etiology, associated malformations and DS were described. At three years of age, children were reevaluated to distinguish between PCH and TCH. Sex; delivery; birth weight; age, TSH, T4, levotiroxine dose (LTd) at start; and LTd at reevaluation were compared between PCH and TCH patients with eutopic thyroid gland. Student’s and Mann Whitney tests were used for continuous variables and Kruskal Wallis test for comparison between groups.
Results: Of 2.889.819 NB, 1331 were confirmed (F:M, 2:1) and treated with a mean LTd of 12.43±2.12 μg/kg/day. Median age at diagnosis was 18 (14–26) days. Incidence was 1:2.171 (P1=1:2.425, P2=1:1.969). Twenty-three children had DS. Fifty-six children (3.45%) showed associated malformations. Of the total group, 675 children were reevaluated. Thirty-one (4.6%) had TCH and 644 (95.4%) had PCH. Etiologies of PCH forms were: athyreosis 161 (25.0%), ectopic disgenetic gland 368 (57.1%), eutopic disgenetic gland 14 (2.2%), and eutopic thyroid gland 101(15.7%). Patients with eutopic thyroid gland (n=132) showed TCH forms in 31 (23.5%) cases. LTd was the only variable that showed significant differences between PCH and TCH patients with eutopic thyroid gland (P<0.0001).
Conclusion: Last years’CH incidence has increased in this program. Associated malformations were found in 3.45% of these CH patients. Transient forms showed a low frequency. Patients who required lower LTd at reevaluation were likely to have TCH forms.
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