Neonatal Diagnosis: Difference between revisions

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Neonates born with congenital hypothyroidism (CH) typically have a normal appearance and no detectable physical signs. Thyroid hormone is required for normal postnatal neural (cognitive) development with newborn screening and thyroid therapy able to be begun within 2 weeks of birth.
Neonates born with congenital hypothyroidism (CH) typically have a normal appearance and no detectable physical signs. Thyroid hormone is required for normal postnatal neural (cognitive) development with newborn screening and thyroid therapy able to be begun within 2 weeks of birth.


The availability of a universal screening program for this hormonal abnormality varies from country to country.<ref>Update of newborn screening and therapy for congenital hypothyroidism. American Academy of Pediatrics, Rose SR; Section on Endocrinology and Committee on Genetics, American Thyroid Association, Brown RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine Society, Foley T, Kaplowitz PB, Kaye CI, Sundararajan S, Varma SK. Pediatrics. 2006 Jun;117(6):2290-303. Review. [http://www.ncbi.nlm.nih.gov/pubmed/16740880 PMID: 16740880]</ref>
The availability of a universal screening program for this hormonal abnormality varies from country to country.<ref><pubmed>16740880</pubmed></ref>


Congenital hypothyroidism can occur through either dysgenesis or agenesis of the thyroid gland development or abnormal thyroid hormone production. A false positive high thyroid stimulating hormone (TSH) can occur, due to the neonatal TSH surge that elevates TSH levels and causes T4 and T3 changes in the first 1 or 2 days after birth.
Congenital hypothyroidism can occur through either dysgenesis or agenesis of the thyroid gland development or abnormal thyroid hormone production. A false positive high thyroid stimulating hormone (TSH) can occur, due to the neonatal TSH surge that elevates TSH levels and causes T4 and T3 changes in the first 1 or 2 days after birth.

Revision as of 09:17, 15 June 2010

Introduction

In the early 1950's Virginia Apgar published the research article that was the basis of a simple diagnostic test, the 10-point Apgar score, for neonatal well-being at birth that continues to be used today.

There are a number of different neonatal screening (newborn screening) programs in different countries testing for various "common" abnormalities and infections. In addition to the Gutherie test there are also physical tests for hip displasia and a growing number of countries testing of newborn hearing.

Neonatal Diagnosis Links: APGAR test | Guthrie test | Hearing test | Electrocardiogram (ECG/EKG) | Tandem mass spectrometry


Diagnosis Links: Prenatal Diagnosis | pregnancy test | amniocentesis | chorionic villus sampling | ultrasound | Alpha-Fetoprotein | Pregnancy-associated plasma protein-A | Fetal Blood Sampling | Magnetic Resonance Imaging | Computed Tomography | Non-Invasive Prenatal Testing | Fetal Cells in Maternal Blood | Preimplantation Genetic Screening | Comparative Genomic Hybridization | Genome Sequencing | Neonatal Diagnosis | Category:Prenatal Diagnosis | Fetal Surgery | Classification of Diseases | Category:Neonatal Diagnosis


Diagnosis Categories

  • Prenatal diagnosis - number of different techniques (non-invasive, invasive) for determining normal development
  • Neonatal diagnosis (APGAR test, Guthrie test)
  • Maternal diagnosis - often pregnancy will expose maternal health problems

Routine Screened Disorders

Biotinidase Deficiency (OMIM)

Congenital Adrenal Hyperplasia (CAH) (OMIM)

Congenital Hypothyroidism (CH)

Congenital Toxoplasmosis

Cystic Fibrosis (CF) (OMIM)

Galactosemia (GAL) (OMIM)

Homocystinuria (OMIM)

Maple Syrup Urine Disease (MSUD) (MCAD | OMIM)

Medium-Chain Acyl-CoA Dehydrogenase Deficiency (MCAD) (OMIM)

Medium-Chain Acyl-CoA Dehydrogenase Deficiency (MCAD)

MCAD deficiency is the most common inherited disorder of mitochondrial fatty acid oxidation in people from northern Europe. It is characterized by an intolerance to prolonged fasting and an inability to generate energy during periods of increased energy demand. The disorder can be severe to fatal in infants.

The other disease characteristics include: recurrent episodes of hypoglycemic coma with medium-chain dicarboxylic aciduria, impaired ketogenesis, and low plasma and tissue carnitine levels.

Gutherie test detected autosomal recessive metabolic disease affects about one in 10 000 people (UK). This mitochondrial protein is encoded by a nuclear gene on chromosome 1 (Gene map locus 1p31) and has a common mutation (985A>G) with a carrier rate of around one in 65.2.

Tandem mass spectrometry

Tandem mass spectrometry (MS/MS) - can screen for PKU and many other diseases simultaneously (up to 21 metabolic diseases).[1]

Endocrine

Congenital Hypothyroidism

Neonates born with congenital hypothyroidism (CH) typically have a normal appearance and no detectable physical signs. Thyroid hormone is required for normal postnatal neural (cognitive) development with newborn screening and thyroid therapy able to be begun within 2 weeks of birth.

The availability of a universal screening program for this hormonal abnormality varies from country to country.[2]

Congenital hypothyroidism can occur through either dysgenesis or agenesis of the thyroid gland development or abnormal thyroid hormone production. A false positive high thyroid stimulating hormone (TSH) can occur, due to the neonatal TSH surge that elevates TSH levels and causes T4 and T3 changes in the first 1 or 2 days after birth.

See also Iodine deficiency.

Gene Tests

A new site developed by NIH "GeneTests" provides medical genetics information resources available at no cost to all interested persons. It contains educational information, a directory of genetic testing laboratories and links to other databases such as OMIM.

Links: Gene Tests

References

  1. <pubmed>17391418</pubmed>
  2. <pubmed>16740880</pubmed>

Search PubMed: neonatal diagnosis | neonatal screening



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Cite this page: Hill, M.A. (2024, May 2) Embryology Neonatal Diagnosis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Neonatal_Diagnosis

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© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G