Illig R, Rodriguez de Vera Roda C
Schweiz Med Wochenschr. 1976 Nov 27;106(48):1676-81.
By a modification of the radioimmunoassay of TSH in plasma, a method has been introduced for the measurement of TSH in dried blood spotted on filter paper. On incubation of filter paper discs (6.5 mm diameter, corresponding to approx. 10 mul blood) for 38 hs has the lower limit of detection was 10 muU/ml TSH 68/38. In 100 blood samples, TSH was measured in plasma as well as in dried blood; the results were comparable and showed complete agreement in patients with high TSH concentrations suffering from primary hypothyroidism. In 16 out of 72 newborn children examined during the first 8 hs of life. TSH was slightly elevated. It would appear that our method is sensitive enough for detection of the physiological postnatal rise in TSH. Among 1400 infants in whom Tsh was measured on the 5th or 6th day simultaneously with routine screening for phenylketonuria (PKU), we found 1 case with markedly elevated TSH levels of greater than 100 muU/ml. The child suffered from congenital goiter. The results of our study show that the measurement of TSH in dried blood spots is possible without particular difficulty. Becasue of the simplicity of blood-sampling, the stability of the TSH, the relatively low cost and the low number of false positive results, this method seems to be suitable for screening of new born infants. It could be carried out conveniently in combination with the screening program for metabolic diseases, which covers practically 100% of infants born in Switzerland. Congenital hypothyroidism is a relatively frequent disease (1:3000-1:7000) in which early commencement of treatment is of great importance for mental development. It would therefore be desirable for all infants to be screened during the first days of life for congenital hypothyroidism.
通过对血浆中促甲状腺激素（TSH）放射免疫测定法的改进，引入了一种用于测量滤纸上干血斑中TSH的方法。将直径6.5毫米的滤纸圆盘（相当于约10微升血液）孵育38小时后，检测下限为10微单位/毫升TSH 68/38。在100份血液样本中，同时测量了血浆和干血中的TSH；结果具有可比性，并且在原发性甲状腺功能减退症且TSH浓度高的患者中显示出完全一致。在出生后8小时内检查的72名新生儿中，有16名TSH略有升高。看来我们的方法对于检测出生后TSH的生理性升高足够灵敏。在1400名在第5天或第6天同时进行苯丙酮尿症（PKU）常规筛查时测量TSH的婴儿中，我们发现1例TSH水平明显升高，大于100微单位/毫升。该患儿患有先天性甲状腺肿。我们的研究结果表明，测量干血斑中的TSH没有特别困难。由于采血简单、TSH稳定性好、成本相对较低且假阳性结果数量少，这种方法似乎适用于新生儿筛查。它可以方便地与代谢疾病筛查项目结合进行，该项目实际上涵盖了瑞士出生的所有婴儿。先天性甲状腺功能减退症是一种相对常见的疾病（1:3000 - 1:7000），早期开始治疗对智力发育非常重要。因此，希望在出生后的头几天对所有婴儿进行先天性甲状腺功能减退症的筛查。
