Related Experiment Video
Updated: May 17, 2026
Evaluation of Hepatic Glucose Production in a Polycystic Ovary Syndrome Mouse Model
Published on: March 5, 2022
Evaluation of congenital hypothyroidism in fars province, iran
Zohreh Karamizadeh1, Hedyeh Saneifard, Golmhossein Amirhakimi
1Division of endocrinology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Evaluating Iran
Area of Science:
- Neonatal screening
- Endocrinology
- Pediatrics
Background:
- Iran's national healthcare includes thyroid-stimulating hormone (TSH) screening for primary congenital hypothyroidism (CH) since 2005.
- This study critically evaluates the CH screening program's effectiveness in Fars province.
Purpose of the Study:
- To assess the performance of the TSH-based neonatal screening program for CH in Fars province, Iran.
- To determine the prevalence and etiological factors of CH in the region.
Main Methods:
- Serum TSH levels were measured in 63,031 newborns (3-5 days old) via heel prick.
- Newborns with TSH ≥5mIU/L were recalled for confirmatory venous blood tests (TSH and T4).
Main Results:
- A prevalence of 1:1465 was identified, with 43 confirmed CH cases.
- Common findings included prolonged jaundice (73%) and fontanel abnormalities (56-55%).
- Thyroid scintigraphy revealed eutopia (67.4%) as the most common presentation, suggesting dyshormonogenesis may be more prevalent than dysgenesis.
Conclusions:
- The TSH cutoff of ≥5mIU/L leads to over-recalling of infants.
- Dyshormonogenesis might be a more frequent cause of CH in Iran than previously reported.
- Programmatic adjustments may be needed to optimize recall rates and diagnostic accuracy.
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 serumT(4) 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 (99m)TC 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.
Related Concept Videos
01:23Hypothyroidism II: Pathophysiology
01:25Hyperthyroidism I: Introduction
01:27Hyperthyroidism II: Pathophysiology
01:27Goiter
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
01:28Graves' Disease I: Introduction