Abstract
The constellation of TSH elevation with normal T4 is classified as LH, by some authors also in newborns. This suggests, that with considerable probability manifest hypothyroidism (MH) will develop.
In a prospective study on 91509 5-day-old-newborns we determined TSH by the RIA of Becton & Dickinson.
570/91509 showed TSH >20 mU/l. In follow-up 40/570 showed persisting TSH elevation, and in addition T4 <6 μg/dl. Thus these 40 had MH. One of the 570 could not be followed up. Of the other 529: 507 further on had normal TSH and T4, in 22/529 TSH persisted elevated, T4 normal. 17/22 had continuously normalizing TSH (T4 always normal). Only in 5/22 TSH persisted elevated, T4 decreasing towards the lower limits of normal. In all five thyroid scan showed lingual ectopia, thus MH (treatment was started before T4 fell below the lower limits of normal).
Thus out of 529 neonates with euthyroxinemic hyperthyrotropinemia TSH elevation was only transient in more than 99 % (524/529), no MH developed. From these results we conclude that it is not adequate to classify every newborn with euthyroxinemic hyperthyrotropinemia as LH.
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Clemens, P., Neumann, S. & Plettner, C. 135 TSH NEWBORN SCREENING: EUTHYROXINEMIC HYPER-THYROTROPINEMIA = LATENT HYPOTHYROIDISM (LH) ?. Pediatr Res 28, 299 (1990). https://doi.org/10.1203/00006450-199009000-00159
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DOI: https://doi.org/10.1203/00006450-199009000-00159
