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Neonatal Thyroid Disease: Testing and Management.

Paul B Kaplowitz1

  • 1Division of Endocrinology, Children's National Health System, George Washington University School of Medicine and the Health Sciences, 111 Michigan Avenue Northwest, Washington, DC 20010, USA.

Pediatric Clinics of North America
|March 2, 2019
PubMed
Summary

Newborn screening identifies thyroid dysfunction, a common cause of treatable mental retardation. Prompt diagnosis and treatment are crucial for preventing abnormal brain development in infants.

Keywords:
Congenital hypothyroidismDelayed TSH elevationNeonatal hyperthyroidismNeonatal hyperthyrotropinemiaNewborn thyroid screening

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Area of Science:

  • Neonatal medicine
  • Endocrinology
  • Pediatric screening

Background:

  • Thyroid dysfunction in newborns requires prompt diagnosis and treatment.
  • Universal newborn screening detects many cases.
  • Primary congenital hypothyroidism is a leading preventable cause of intellectual disability.

Purpose of the Study:

  • To review and discuss the management of thyroid dysfunction presenting in the first month of life.
  • To highlight the importance of timely intervention for congenital hypothyroidism.
  • To address challenges in interpreting borderline thyroid test results in neonates.

Main Methods:

  • Review of current literature and clinical guidelines.
  • Discussion of diagnostic approaches for neonatal thyroid disorders.
  • Analysis of treatment strategies for hypothyroidism and hyperthyroidism in newborns.

Main Results:

  • Congenital hypothyroidism is the most common treatable cause of mental retardation.
  • Abnormal thyroid tests in newborns can be difficult to interpret, necessitating careful follow-up.
  • Neonatal hyperthyroidism is less common but also requires management.

Conclusions:

  • Early detection and treatment of thyroid dysfunction in newborns are critical for normal neurodevelopment.
  • A systematic approach is needed for managing ambiguous thyroid function tests.
  • Effective management of neonatal thyroid disorders prevents long-term cognitive impairment.