Fatores preditores para o diagnóstico de hipotireoidismo congênito permanente e variação temporal da incidência em Sergipe, Brasil.

• Autor(a) principal: Felix, Hérika Mesquita Gumes
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/jspui/handle/riufs/18446
• topic: Hipotireoidismo congênito; Tireotropina; Tiroxina; Triagem neonatal; Congenital hypothyroidism; Thyrotropin; Thyroxine; Neonatal screening; CIENCIAS DA SAUDE::MEDICINA

Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). Although the importance of thyroxine in myelination of the infant brain is undisputed, the benefits of treating HCT in relation to neurodevelopment remains controversial. Our objectives were to determine predictive factors for HCP and to verify changes in the incidences of PCH and TCH from 2004 to 2015. Of the 172,547 newborns from 2011 to 2015, 140,325 newborns were screened by the neonatal screening program in Sergipe (81.32% coverage), of which 767 (0.54%) showed changes in the filter paper test (neonatal TSH greater than 5.2 μU/mL). Fifty- eight (7.5%) children were not located by the social service for the confirmatory serological test and 391 (50.97%) children were excluded because their initial serum TSH was lower than 4.2 μU/mL. Of the 315 remaining medical records, 165 children were evaluated up to 3 years of age and had the diagnosis of PCH and TCH confirmed, 88 of which underwent thyroid imaging. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and from 2011 to 2015. (Sergipe DATASUS-MS). 66 children were diagnosed with PCH and 99 with TCH. Eighty-one percent of children with PCH and all children with TCH with thyroid imaging had gland in situ. The most important predictors for PCH were baseline serum TSH, marginally higher than filter paper TSH, followed by a large distance from baseline serum free T4. The mean incidences of PCH (1:4166 to 1:2126 odds ratio: 1.95, 95% CI 1.36 to 2.95, p<0.0001) and TCH (1:1900 to 1:1417 odds ratio 1.33, 95%, CI 1.02 to 1.77, p=0.038) increased over time. In conclusion, the most important predictors of PCH are initial serum TSH and filter paper TSH. The mean incidences of PCH and TCH increased over time in our series for unknown reasons.