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Outcome of congenitally hypothyroid screening program in isfahan: iran from prevention to treatment

Mahin Hashemipour1, Elham Hashemi Dehkordi, Silva Hovsepian

  • 1Professor of Pediatric Endocrinology, Department of Pediatrics, Isfahan Endocrine & Metabolism Research Center (IEMRC), Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.

International Journal of Preventive Medicine
|May 14, 2011
PubMed

Insights

Early treatment for congenital hypothyroidism (CH) is vital. This study in Isfahan found that while treatment initiation was timely, optimal outcomes for CH patients require early, high-dose interventions, especially for severe cases.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Neonatal Screening

Background:

  • Congenital hypothyroidism (CH) requires prompt treatment to prevent neurodevelopmental issues.
  • Isfahan has a notable prevalence of CH, necessitating local treatment outcome evaluations.

Purpose of the Study:

  • To assess the treatment outcomes of CH patients identified through a screening program in Isfahan.
  • To evaluate the timeliness and effectiveness of CH treatment based on key biochemical markers.

Main Methods:

  • A cohort of CH neonates diagnosed via screening in Isfahan (May 2002-September 2009) was studied.
  • Treatment quality was assessed by monitoring age at treatment initiation and thyroid-stimulating hormone (TSH) and thyroxine (T4) levels.
  • Biochemical markers were evaluated pre-treatment, post-treatment, and during the first two years of life.

Main Results:

  • The prevalence of CH was identified as 1 in 420 live births.
  • The mean age for initiating treatment was 22.9 ± 13.2 days, with 93.7% starting before day 45.
  • Initial post-treatment T4 and TSH levels were outside the acceptable range in 3.9% and 9.8% of patients, respectively, though they normalized over time, with T4 normalizing faster than TSH.

Conclusions:

  • Treatment initiation age was within acceptable limits.
  • Optimal CH management, particularly for severe cases, necessitates both early and high-dose therapeutic interventions.
  • Further research is required to elucidate treatment outcomes across diverse etiologies of CH.
Abstract

Keywords:
Congenital hypothyroidismIranIsfahanTreatment

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