Jones Jeremy H, Donaldson Malcolm D C
Department of Child Health, Royal Hospital for Sick Children, Glasgow, UK.
J Pediatr Endocrinol Metab. 2009 Nov;22(11):1017-25. doi: 10.1515/jpem.2009.22.11.1017.
Prompt and adequate management of newly diagnosed congenital hypothyroidism (CH) has been shown to optimise intellectual outcome.
A questionnaire survey of the British Society for Paediatric Endocrinology and Diabetes (BSPED) membership was undertaken, examining current clinical practice in neonatal CH. Results were compared with published management guidelines from Europe and the UK.
The response rate was 86%. The majority were largely compliant with both guidelines. 43% review newly referred infants on the day of notification. However, 26% treat severe CH with < 10 microg/kg/day thyroxine and nearly 20% do not follow up until at least 14 days after initiating treatment, in contrast to both guidelines. Despite a new liquid T4 preparation being licensed, respondents preferred tablet T4.
Rapidity of assessment and adequate follow up of suspected CH is critical to outcome. Existing European and UK guidelines should be reviewed and expanded to incorporate new evidence, together with increased advice on preparation and administration of T4.
已证实对新诊断的先天性甲状腺功能减退症（CH）进行及时且充分的管理可优化智力发育结果。
对英国儿科学内分泌与糖尿病学会（BSPED）的成员进行了问卷调查，调查新生儿CH的当前临床实践。将结果与欧洲和英国已发布的管理指南进行比较。
回复率为86%。大多数人在很大程度上符合这两个指南。43%在收到通知当天对新转诊的婴儿进行检查。然而，与两个指南相反，26%用低于10微克/千克/天的甲状腺素治疗重度CH，近20%在开始治疗后至少14天才进行随访。尽管一种新的液体T4制剂已获许可，但受访者更喜欢T4片剂。
对疑似CH的评估速度和充分随访对结果至关重要。应审查并扩展现有的欧洲和英国指南，以纳入新证据，并增加有关T4制剂制备和给药的建议。
