Diagnostic indicators of congenital hypothyroidism

The article is expertly consulted by Master, Doctor Phan Thi Cam Van - Department of Pediatrics - Neonatology - Vinmec International General Hospital Da Nang. He has 07 years of experience as a Resident Doctor and a Pediatrician - Neonatal Doctor at Hue Central Hospital and Hue University Hospital of Medicine and Pharmacy. In particular, he has experience in newborn care and treatment, neonatal resuscitation, respiratory diseases, digestive diseases, feeding, common problems of newborns.

Congenital hypothyroidism is defined as a significant decrease or loss of thyroid function in a child at birth, affecting the child's growth, physical and mental development. However, if detected and treated early, children will have a chance to develop normally.

Congenital hypothyroidism is defined as a significant decrease or loss of thyroid function in a child at birth. The thyroid is a butterfly-shaped gland located in the front of the neck. This thyroid gland uses iodine from the food you take into your body every day to make a hormone called T4 (thyroxine). T4 hormone plays a very important role (survival) for the development and maturation of children. In children with congenital hypothyroidism, the thyroid gland is not functioning properly, causing the body's T4 levels to be low, the pituitary gland is forced to produce more TSH to stimulate the thyroid gland to produce T4.
One in every 3,000-4,000 babies is born with congenital hypothyroidism. If the newborn has congenital hypothyroidism without timely detection and treatment, within the first 2-3 weeks after birth, the baby often has prolonged jaundice, the skin color is often lead gray, pale. Babies often sleep a lot, don't respond to outside noises, cry less, stop sucking or suck less, lethargic when feeding, slow to gain weight, cold hands and feet, tongue sticking out... Compared to normal babies Usually, children with congenital hypothyroidism often have delays in physical development (slow on weight gain and height development) and mental development (children are inflexible, unable to study...)

Children with congenital hypothyroidism at birth have vague symptoms, so it is difficult for parents to recognize. However, when parents notice the symptoms of the disease, it is already at a late stage because the child's nervous system develops very quickly. Therefore, if treatment is delayed, children will be physically and mentally retarded compared to their peers.
In fact, some children are admitted to the hospital with the reason that they have mental and physical retardation, as well as height retardation, memory loss or another medical condition. Therefore, it is best for infants to be diagnosed early with a newborn screening program.
48 hours after birth, the baby will have a heel or venous blood sample collected on blotting paper to test for TSH and T4. If the TSH is elevated, doctors will suspect the child has congenital hypothyroidism.

T4 concentration: is an important parameter in evaluating thyroid function. More than 99% of T4 is associated with proteins. Thus, alteration of this protein can alter T4 levels. The concentration of T4 in the blood of term infants is about 6.4-23.2 mcg/dL.

Free T4 : reflects the availability of thyroid hormone to tissues. This level varies by age: full-term infants :2-5.3 ng/dL; Children 25-30 weeks: 0.6-3.3 ng/dL.
TSH : is a valuable test in the evaluation of thyroid disorders, especially in primary hyperthyroidism. Blood levels are about 2.5-18 mU/L. When T4 results are low and TSH >40 mU/L is said to be congenital hypothyroidism
T3 levels: very useful in the diagnosis and treatment of hyperthyroidism. Blood levels of T3 are very low during the fetal stage around 20-75 ng/dL. In the short postpartum period this level rises to 100-400 ng/dL. In patients with hyperthyroidism this level may be > 400 ng/dL. In unhealthy preterm infants, low T3 can be a sign of non-thyroid disease syndrome.
Thyroid -binding Globulin (TBG): TBG is measured by radioimmunoassay. Knowing the T3 level can indirectly know the TBG level.
The ideal time to screen for congenital hypothyroidism is from day 2 to day 6 after birth (average 3 days after birth).
Low T4 levels < 7 μg/mL and TSH > 40 μg/mL indicate congenital hypothyroidism. The borderline TSH concentration (20 - 40 μg/mL) should be repeated.
Timely diagnosis and treatment of congenital hypothyroidism in infancy is very important for normal brain and physical development. Vinmec International Hospital currently has a newborn screening test service to help detect diseases: G6PD deficiency, congenital hypothyroidism, congenital adrenal hyperplasia, congenital hemolysis (Thalassaemia). ..100% of babies born at Vinmec are screened for congenital hypothyroidism and other newborn screenings.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.