Evolution to permanent or transient conditions in children with positive neonatal TSH screening tests in Sergipe, Brazil.
OBJECTIVE
To assess the evolution to permanent or transient conditions in children with positive neonatal TSH tests in Sergipe, Brazil, from 2004 to 2010.


METHODS
Out of 193,794 screened newborns, 713 presented a neonatal TSH level higher than the local cutoff (5.2 µU/mL). From the confirmatory serum TSH values, the children were diagnosed with initial congenital hypothyroidism (CH) or suspect CH. From the evolution, they were classified as permanent CH, hyperthyrotropinemia, or transient TSH elevation. The mean incidence of each final condition was calculated for the total period of time.


RESULTS
The initial diagnosis included 37 CH (18.1%) and 167 suspect CH (81.9%) cases. The final diagnosis included 46 cases of permanent CH (22.5%), 56 of hyperthyrotropinemia (27.5%), and 102 of transient TSH elevation (50.0%). Out of the 37 cases of initial CH, 23 (62.2%) had permanent CH, nine (24.3%) had hyperthyrotropinemia, and five (13.5%) had transient TSH elevation. Out of the 167 suspect CH cases, 23 (13.8%) had permanent CH, 47 (28.1%) had hyperthyrotropinemia and 97 (58.1%) had transient TSH elevation. The mean incidence after the follow up was 1:4,166 for permanent CH, 1:3,448 for hyperthyrotropinemia, and 1:1,887 for transient TSH elevation. Eighty-six percent of the children with an initial diagnosis of CH and 41.9% with suspect CH had a permanent condition (CH or hyperthyrotropinemia).


CONCLUSIONS
The follow-up of children with an initial diagnosis of CH or suspect CH is necessary to determine whether the disorder is permanent because predicting the evolution of the condition is difficult.
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Diana M
DM
Matos
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Roberto J R
RJ
Ramalho
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Bruno M
BM
Carvalho
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Maria Augusta C T
MA
Almeida
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Luciana F D
LF
Passos
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Talmay T S
TT
Vasconcelos
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Enaldo V
EV
Melo
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Carla R P
CR
Oliveira
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Elenilde G
EG
Santos
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Karla F
KF
Resende
Departamento de Medicina, Hospital Universitário, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil.
Manuel H
MH
Aguiar-Oliveira
D001938:Brazil / Q000453:epidemiology; D003409:Congenital Hypothyroidism / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D011237:Predictive Value of Tests; D012015:Reference Standards; D012016:Reference Values; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood; D013997:Time Factors
D013972:Thyrotropin; D013974:Thyroxine