en |
Evaluation of Congenital Hypothyroidism in Fars Province, Iran
Karamizadeh, Zohreh; Saneifard, Hedyeh; Amirhakimi, Golmhossein; Karamifar, Hamdollah & Alavi, Mehrsadat
Abstract
Objective: In Iran thyroid-stimulating hormone (TSH) based neonatal screening program is included in health
care services from 2005 for detection of patients with primary congenital hypothyroidism (CH). This study was
performed for a critical evaluation of the screening program primary congenital hypothyroidism in Fars province,
Iran.
Methods: From November 2006 to September 2007, TSH serum concentrations of 63031 newborns, 3 to 5
days old born in Fars province, were measured by heel prick. The newborns with TSH ≥5mIU/L were
recalled for measurement of serumT4 and TSH in venous blood samples
Findings: Of 127 recalled subjects, 43 were confirmed to be hypothyroid, showing a prevalence of 1:1465
with F:M ratio of 1.05:1. The most common clinical and radiological findings were prolonged jaundice (73%),
large anterior fontanel (56%), wide posterior fontanel (55%), absence of distal femoral epiphysis (20%), and
umbilical hernia (11%). Scintigraphy of the thyroid with 99mTC revealed eutopia (67.4%), hypoplasia (23.3%),
agenesis (4.7%) and ectopia (2.3%).
Conclusion: It is concluded that a cut off value of TSH≥5mIU/L overestimates recalling the number of patients
with CH. The most common cause of congenital hypothyroidism is not dysgenesis of the gland and perhaps
dyshormonogenesis in Iran is more common than what is reported in other countries.
Keywords
Congenital Hypothyroidism; Thyroxin; Thyroglobolin; Thyroid Dysgenesis; Fars province
|