Endocrine Abstracts

Introduction :

CH diagnosis has advanced from no screening in the past , to cord blood

screening -free thyroxine(FT4) ,Tawam and Thyroid Stimulating Hormone (TSH),Oasis Hospitals- to the present National Screening Programme (NSP) for capillary TSH from January ,1998.

Aim :

To screen all newborns and to scan and treat all positive cases before 21 days and to monitor progress and outcome.

Method :

Delfia heel prick samples are taken on day 4 or 5 .Positive cases (>25mu/l) are scanned and treated.

Results:

Past : Prescreening , Diagnosis are often late or wrong .

Present:from January 1998 to June 2003 Cord FT4 - 12,587 screened ,6 positive ,5 missed.

Cord TSH 10,386 screened .3 positive ,1 missed .The missed cases were picked up on the NSP.NSP :863662 babies screened (up to the end of 2000),55 positive.

Incidence 1in 1570.

Al Ain District coverage rose from 50%(1998) to 98%(2002).102 cases seen out of the total 126 cases nationwide. Technetium99 scan 91-ectopic 35,athyreosis 10,Eutopic 44, 2 uninterpreatable .

Treatment started by 21 days in 91%.Transient CH- so far 8 -6 dyshormonogenesis ;

2 maternal antibodies.

2 babies with CH have a retarded older sibling diagnosed late in the prescreening era. Almost all NSP babies are growing and developing normally.

Throughout there has been increased professional and community acceptance of the NSP, and improved coverage ,logistics and timelines.

The future-continuous evaluation and improvement of the programme .

Community patient support group.

Genetic studies and determination of the metabolic block in Eutopic cases.

Conclusions:

CH (especially from dyshormonogenesis) is relatively high in the UAE .

Cord blood screening cannot be the sole screening method.

The NSP is generally accepted and clearly worthwhile .

With continuing improvement and refinement the future looks bright.