Etiology of congenital hypothyroidism using thyroglobulin and ultrasound combination

Endocrine Journal

Cristine B. Beltrão¹  Tomoco Watanabe²  Marcelo T. Sapienza²  Maria C. Chammas²  Suemi Marui¹  Adriana G. Juliano² 

[1] Laboratório de Endocrinologia Celular e Molecular, LIM 25, Unidade de Tireóide, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil;Departamento de Radiologia, InRAD, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

关键词: Thyroglobulin;    Thyroid dysgenesis;    Congenital hypothyroidism;    Scintigraphy;    Ultrasound;   

DOI  :  10.1507/endocrj.K10E-009

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(37)Cited-By(2)Methods currently employed to establish the etiology of congenital hypothyroidism include thyroid ultrasound and scintigraphic exams. Thyroglobulin is a protein almost exclusively secreted by thyroid tissue and indirectly reflects the amount of follicular cells. Even though thyroglobulin is easy to measure, it has been not frequently used because of discordant results to distinguish mainly athyreosis and ectopy (dysgenesis). Knowing the differences in inheritance and prognosis of thyroid dysgenesis and dyshormonogenesis, it is important to define the etiology of CH, combining tools that are easy, fast and available in most medical centers. Our objective was to evaluate and compare color Doppler ultrasound and serum thyroglobulin with radionuclide scan to define the etiology of congenital hypothyroidism. We evaluated 38 children above 3 years-old off-treatment that performed serum thyroglobulin by immunofluorometric assay, color Doppler ultrasound and radionuclide study. On color Doppler ultrasound, 11 patients had athyreosis, 5 ectopic glands, being 1 associated to hemiagenesis. Twenty one had topic thyroid (3 goiters, 10 normal, 8 hypoplastic). Hemiagenesis and cystic lesion were not revealed by radionuclide scan. We observed substantial agreement between color Doppler ultrasound and radionuclide scan (kappa=0.745, p<0.0001). Serum thyroglobulin in athyreosis ranged from <1.0 to 18.7 μ g/L. Patients with ectopic glands showed wider thyroglobulin range (4.5 to 123 μ g/L, median 28.4 μ g/L). Only one patient showed thyroglobulin deficiency. By using color Doppler ultrasound and serum thyroglobulin levels as valuable combined tools, we established the etiology of congenital hypothyroidism limiting excessive and harmful exams in children, like radionuclide scan.

【 授权许可】

Unknown