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YENİDOĞAN KONJENİTAL HİPOTİROİDİZM TARAMA SONUÇLARININ DEĞERLENDİRİLMESİ

EVALUATION OF ANEONATAL CONGENITALHYPOTHYROIDISM SCREENING PROGRAMME

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Abstract (2. Language): 
Objective: The aim of the study was to determine the congenital hypothyroidism incidence in 2007 by screening and also to determine recall rate among newborn babies at Gazi University Faculty of Medicine between October 2000 and January 2007 by the evaluation of TSH screening results. Materials and methods: TSH levels were measured on blood taken from 12.626 babies onto special filter papers. The cut-off level to recall was determined as >10, >10, >20 or >25 μU/ml at different periods through October 2000 - January 2007. Results: The incidence of congenital hypothyroidism was found to be 1/2525 and recall rate was found to be 8.99 % for the overall period (21.76 %, 6.83 %, 6.72 %, 4.41 % according to different recall threshold levels, respectively). 1136 subjects who were recalled were studied for TT4, fT4 and TSH. According to the results, 45 newborns were taken for follow up, and after a three year follow-up, 27 had hyperthyrotropinemia and 5 had persistant congenital hypothyroidism (3 had compansated hypothyroidism). Thirteen subjects are still being followed up, as their follow-up period has not yet reached three years. As a result of our study, TSH cut off level was determined as 22.15 μU/ml with 100 % sensitivity and 91.1 % specificity. Conclusion: In summary the incidence of congenital hypothyroidism and recall percent is higher in our country compared to many countries in the world. Many newborns in Turkey have the risk of congenital hypothyroidism as shown by many pilot studies held in different regions of our country previously. All newborn in our country will be screened and national incidence of congenital hypothyroidism will be estimated by the national screening programme that initiated in January 2007.
Abstract (Original Language): 
Amaç: Ekim 2000 - Ocak 2007 tarihleri aras›nda Gazi Üniversitesi T›p Fakültesi Hastanesinde do¤an yenido¤anlardan al›nan TSH tarama sonuçlar›n› de¤erlendirerek konjenital hipotiroidizm s›kl›¤›n› ve geri ça¤›rma oran›n› belirlemektir. Gereç ve Yöntem: On iki bin alt› yüz yirmi alt› yenido¤an›n topuklar›ndan özel filtre ka¤›tlar›na kan al›narak TSH de¤erleri ölçüldü. Taramada konjenital hipotiroidizm aç›s›ndan geri ça¤r›lma eflik de¤eri Ekim 2000 - Ocak 2007 tarihleri aras›nda farkl› dönemlere göre >10, >10, >20 ve >25 μU/ml olarak al›nd›. Bulgular: Konjenital hipotiroidizm s›kl›¤› 1/2525 ve geri ça¤r›lma oran› toplamda % 8,99 (dönemlere göre s›ras›yla % 21,76, % 6,83, % 6,72 ve % 4,41) olarak bulundu. Geri ça¤r›lan 1136 olguda serum TT4, sT4 ve TSH çal›- fl›ld›. Sonuçlara göre 45 yenido¤an takibe al›nd› ve 3 y›ll›k izlemleri sonras›nda 27’sinde geçici hipertirotropinemi, 5’inde kal›c› konjenital hipotiroidizm (3’ü kompanse hipotirodi) saptand›. Onüç olgu ise 3 y›llar› henüz dolmad›¤› için takipleri devam etmektedir. Çal›flma sonucunda TSH ‘cut off ’ de¤eri %100 duyarl›l›k ve %91,1 özgünlük ile 22,15 μU/ml olarak saptand›. Sonuç: Bölgemizdeki konjenital hipotiroidizm s›kl›¤› ve geri ça¤r›lma oranlar› dünyadaki birçok ülkeden yüksektir. Türkiye’nin geneli konjenital hipotiroidizm aç›s›ndan risk alt›ndad›r. Daha önceden yurdumuzun çeflitli bölgelerinde yap›lm›fl olan pilot çal›flmalardaki konjenital hipotiroidizm s›kl›klar› da bunu göstermektedir. Ocak 2007 tarihinden itibaren bafllayan ulusal düzeyde konjenital hipotiroidizm tarama program› ile ülkemiz genelinde tüm yenido¤ an çocuklar›m›z taranacak ve genel konjenital hipotiroidizm s›kl›¤› tespit edilmifl olacakt›r.

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