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Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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...
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Author Spotlight: In Vivo Assessment of Thyroid Hormone Disruption Using the THAI Mouse Model
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Neonatal Screening for Hyperthyroidism Proof of Concept.

Maïa Banigé1, Dulanjalee Kariyawasam2, Valerie Gauthereau3

  • 1Department of Neonatal Pediatrics and Intensive Care, Hôpital Universitaire Cochin-Port Royal, Assistance Publique Hôpitaux de Paris, (AP-HP), Paris, France.

The Journal of Clinical Endocrinology and Metabolism
|December 11, 2021
PubMed
Summary
This summary is machine-generated.

Early screening for neonatal hyperthyroidism (NH) using thyroid-stimulating hormone (TSH) levels on day three can identify severe cases. This allows for timely treatment to prevent cardiac complications and improve infant outcomes.

Keywords:
Guthrie testneonatal hyperthyroidismneonatal screeningpublic healthstimulating hormonethyroid

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Area of Science:

  • Neonatal screening
  • Endocrinology
  • Public health

Background:

  • Neonatal hyperthyroidism (NH) can lead to severe, potentially fatal thyrotoxicosis.
  • Early intervention is crucial to prevent cardiac complications associated with NH.
  • Current screening methods may not optimally detect NH early.

Purpose of the Study:

  • To evaluate the feasibility of screening for NH using thyroid-stimulating hormone (TSH) levels from dried blood spots.
  • To determine the effectiveness of TSH screening on the third postnatal day for detecting severe NH.
  • To assess the clinical implications and cost-effectiveness of implementing NH screening.

Main Methods:

  • Retrospective case-control study utilizing data from 280,000 infants (2007-2014).
  • Comparison with 1,362,564 control infants from the Ile-de-France region.
  • Analysis of thyroid-stimulating hormone (TSH) values in dried blood spots collected on the third postnatal day.

Main Results:

  • A TSH cutoff of <0.18 mIU/L demonstrated 71% sensitivity and 99% specificity for detecting severe NH.
  • The TSH screening value was the strongest predictor of NH (P < .00001) with an AUC of 0.98.
  • Positive and negative predictive values were 81% and 98%, respectively, indicating high accuracy.

Conclusions:

  • TSH screening on the third postnatal day is a feasible method for detecting severe neonatal hyperthyroidism.
  • An optimal cutoff of 0.18 mIU/L for TSH can facilitate earlier diagnosis and presymptomatic treatment.
  • This screening approach offers a small additional cost and ensures better outcomes for infants with NH.