[Congenital hypothyroidism: causes for delayed initiation of treatment].
The aim of neonatal screening programs for congenital hypothyroidism is to ensure early treatment in order to prevent brain dysfunction. There are several reasons why infants are missed in the screening program. We report on three patients with congenital hypothyroidism, who had a pathological screening result and initiation of therapy was delayed. The first patient had an increased TSH level, but she was missed because of mistakes in the confirmatory serum test. During the follow-up the patient showed typical symptoms of hypothyroidism and got a thyroxine supplementation not before the age of three years. The second patient did not get a therapy before the age of six months because of the noncompliance of the parents and physicians. The third patient had a central hypothyroidism. The neonatal screening-program revealed no measurable TSH activity. Although the child had clinical signs of a severe hypothyroidism diagnosis was not made before the age of 5.5 months. Although different reasons are known for screening errors, all these 3 patients were missed because of failures in the follow-up of a pathological screening result, indicating a poor quality in the follow-up procedure.
Doeker
B
B
Vestische Kinderklinik Datteln, Universität Witten-Herdecke.
Andler
W
W
D003409:Congenital Hypothyroidism; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000188:drug therapy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D011237:Predictive Value of Tests; D011785:Quality Assurance, Health Care; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage
D013972:Thyrotropin; D013974:Thyroxine
Angeborene Hypothyreose: Ursachen eines verzögerten Behandlungsbeginns.