title: Congenital hypothyroidism with delayed TSH elevation in low-birth-weight infants: incidence, diagnosis and management.
abstract: OBJECTIVE
  To evaluate the incidence of congenital hypothyroidism (CH) with delayed TSH elevation among low-birth-weight (LBW) newborns in North-Eastern Italy and to verify if they need a second or third screening.
  
  
  METHODS
  Analysis of clinical and biochemical data of newborns affected by CH with delayed TSH elevation identified by neonatal screening.
  
  
  METHODS
  Data of all newborns with birth weight (BW) <2500 g and evidence of delayed TSH elevation at newborn screening were collected between 2011 and 2014. Confirmatory tests were based on serum TSH and FT4 levels. All their clinical signs at diagnosis were reported.
  
  
  RESULTS
  57.5% of LBW newborns with delayed TSH increase at neonatal screening presented a CH with delayed TSH elevation and began a treatment with l-thyroxine. The incidence of this condition in North-Eastern Italy is therefore 1:908. The remaining infants presented a subclinical hypothyroidism (21.25%) or a complete normal serum thyroid function (21.25%). These data could be drawn only from a retesting strategy of neonatal screening.
  
  
  CONCLUSIONS
  Our report describes the incidence of CH with delayed TSH rise in North-Eastern Italy and differentiates this clinical condition from other thyroid dysfunctions of preterm or LBW newborns. The second-screening strategy for CH in neonates with BW < 2500 g proved useful in detecting newborns who otherwise would not be identified at the first screening.
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy paolocavarzere@yahoo.it.
authors: Paolo
authors: P
authors: Cavarzere
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Marta
authors: M
authors: Camilot
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Florina Ion
authors: FI
authors: Popa
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Silvana
authors: S
authors: Lauriola
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Francesca
authors: F
authors: Teofoli
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Rossella
authors: R
authors: Gaudino
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Monica
authors: M
authors: Vincenzi
authors: Pediatric ClinicDepartment of Mother and Child, University Hospital of Verona, Verona, Italy.
authors: Franco
authors: F
authors: Antoniazzi
mesh_terms: D001724:Birth Weight; D003409:Congenital Hypothyroidism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D015997:Neonatal Screening; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013972:Thyrotropin; D013974:Thyroxine