สาเหตุของภาวะพร่องไทรอยด์ฮอร์โมนแต่กำเนิด : ประสบการณ์ 20 ปี ในโรงพยาบาลสงขลานครินทร์

Abstract

introduction:%20Congenital%20hypothyroidism%20(CH)%20is%20one%20of%20the%20common%20causes%20of%20mental%20retardation%20which%20is%20preventable%20by%20early%20detection%20and%20treatment%20with%20thyroxine%20supplementation.%20In%20Thailand,%20neonatal%20TSH%20screening%20was%20implemented%20nationwide%20in%202004-2005.%20Objective%3A%20To%20determine%20the%20etiologies%20of%20CH%20before%20and%20after%20the%20implementation%20of%20neonatal%20TSH%20screening%20program%20(1994-2005%20and%202006-%0A2012).%20Methods%3A%20The%20medical%20records%20of%20pediatric%20patients%20aged%200-15%20years%20who%20were%20diagnosed%20as%20primary%20congenital%20hypothyroidism%20at%20the%20Pediatric%20Endocrine%20Clinic%20of%20Songklanagarind%20Hospital%20during%201995-2013%20were%20retrospectively%20reviewed.%0AResults%3A%20There%20were%20416%20patients%20diagnosed%20with%20congenital%20hypothyroidism%3A%20165%0Acases%20during%201995-2005%20(average%2015%20cases/year)%20and%20251%20cases%20during%202006-2012%20(average%2036%20cases/year).%20Before%20neonatal%20TSH%20screening%20implementation,%20the%20most%0Acommon%20etiology%20of%20congenital%20hypothyroidism%20was%20overt%20permanent%20congenital%20hypothyroidism%20(66.1%25),%20and%20transient%20congenital%20hypothyroidism%20was%20diagnosed%20in%20only%204.8%25%20of%20the%20cases.%20After%20neonatal%20TSH%20screening%20implementation,%20the%20most%20common%20etiology%20of%20congenital%20hypothyroidism%20was%20mild%20permanent%20congenital%20hypothyroidism%20(39.4%25),%20with%20transient%20congenital%20hypothyroidism%20was%20increasingly%20diagnosed%20in%2027.1%25%20of%20the%20cases%20and%20overt%20congenital%20hypothyroidism%20was%20found%20in%2033.5%25%20of%20the%20cases%20Conclusion:%20Neonatal%20TSH%20screening%20resulted%20in%20the%20increased%0Adetection%20of%20patients%20with%20mild%20forms%20of%20permanent%20and%20transient%20CH%20cases,%20which%20would%20not%20have%20been%20detected%20before%20the%20neonatal%20TSH%20screening%20was%20implemented.