ESPE Abstracts (2021) 94 P2-461

1Hospital Universitario Cruces, BioCruces, Barakaldo, Vizcaya, Spain; 2Hospital Universitario Marqués de Valdecilla, Santander, Spain; 3Complejo Universitario de Navarra, Pamplona, Spain; 4Hospital Universitario Donostia, Donosti, Spain; 5Hospital de Basurto, Bilbao, Spain; 6Hospital Universitario Araba, Vitoria, Spain; 7Hospital Universitario Cruces, BioCruces, CIBERER, Barakaldo, Vizcaya, Spain; 8Programa de Cribado Neonatal, Salud Pública Gobierno del País Vasco, Zamudio, Vizcaya, Spain; 9Servicio de Epidemiología y Prevención Sanitaria, Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain; 9Dirección General de Salud Pública, Gobierno de Cantabria, Santander, Spain

Introduction: 2020 ESPE guidelines recommend early reevaluation in primary congenital hypothyroidism (PCH) with thyroid in situ (TIS) and with levothyroxine dose lower than 3 mg/kg/day.

Materials and Methods: Our Congenital Hypothyroidism screening program determine TSH and TT4 in dried blood spot (DBS) at 48 hours of life. A second DBS (DBS2) is indicated when the first is positive. Multicenter retrospective study (05/2016-05/2020; 105,858 screenings) of all newborns ≥33 weeks and/or ≥1500 grams with TSH≥10 mIU/l in DBS2. Serum TSH and FT4 were determined to make final diagnosis: PCH if TSH>20 mIU/l and hyperthyrotropinemia (HT) if TSH 10-20 mIU/l. Levothyroxine dose was assessed at diagnosis, at 6 and 12 months. Differences were related to phenotype.

Values: median (range)Dysgenesis/hypoplasias n =25TIS n =7Hyperthyrotropinemias n =5
Serum TSH (mIU/l)300 (73–779)a82.9 (76.3–89.5)a15.9 (9.5–1.6)a
Serum FT4 (ng/dl)0.7 (0.2–1.2)a,c1.7 (1.6–1.8)c1.3 (1.2–1.5)
Gestacional age (weeks)40 (37–42)39 (35–40)40 (35–41)
SDS-newborn lenght0.2 (-2.0–1.9)0.0 (-1,1–2.5)-0.5 (-3.4–1.3)
SDS-newborn weight0.4 (-2.0–2.0)0.1 (-1.3–0.5)-0.2 (-1.8–0.7)
Levothyroxine start (days)7.0 (4.0–16.0)b7.0 (5.0–15.0)18.0 (10.0–44.0)b
Starting dose (µg/kg/day)12.5 (2.9–17.0)b,e6.5 (3.5–13.0)e3.5 (3.0–6.0)b
6 month dose (µg/kg/day)4.5 (2.0–10.0)a,d3.0 (1.6–3.8)d1.6 (1.1–2.7)a
12 month dose (µg/kg/day)3.9 (1.3– 6.0)a2.5 (1.3–3.1)a2.0 (1.2–2.0)a
U Mann-Whitney:a P:0.000;b P:0.001;c P:0.002;d P:0.003;eP:0.004

• DBS2 TSH and serum TSH had a good correlation
• Dysgenesis is the most common cause of PCH
• Early reassessment at 6 month of life could be consider in TIS and HT.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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