Category Archives: Endocrine

Tip 223: congenital hypothyroidism 2

About 0.2% of infants having the national newborn blood spot test have a high TSH requiring recall. External link: UK National Screening Committee (2012). Congenital hypothyroidism is suspected. Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill. Previously published: 17/02/15

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Tip 221: congenital hypothyroidism

The usual mode of presentation is by the finding of an elevated TSH detected on the Newborn Screening Programme, as neonates are usually subclinically affected. It affects 1 in 3000 live births. If clinical features are present, they include: dry skin, … Continue reading

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Tip 205: neonatal thyrotoxicosis 2

Hyperthyroidism in the newborn is usually due to transplacental passage of thyroid stimulating immunoglobulins from a mother with Graves’ disease, or, more rarely, Hashimoto’s thyroiditis. It is transient, limited by the clearance of maternal antibody from the baby’s circulation. The … Continue reading

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Tip 203: neonatal thyrotoxicosis

Babies at risk of neonatal thyrotoxicosis are: babies of mothers with a current or past history of Graves’ disease babies from families with a family history of neonatal thyrotoxicosis secondary to TSH receptor mutations (rare) These babies should have TSH/T4 … Continue reading

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Tip 140: cortisol

Very preterm neonates are at increased risk for cortisol insufficiency in acute illness and stress because of immaturity of the adrenal gland. The adrenal neocortex generally does not synthesize cortisol until ~ 30/40. Before this, the fetus uses progesterone from the placenta to … Continue reading

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Tip 11: congenital adrenal hyperplasia

Incidence is 1:18,000 (girls=boys) ~90% have 21-hydroxylase deficiency ~50% present as a neonate (girls mainly with virilised genitalia, boys mainly with salt-wasting crisis) External links: Khalid, JM., et al. Incidence and clinical features of congenital adrenal hyperplasia in Great Britain. Arch … Continue reading

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Tip 140: cortisol

Very preterm neonates are at increased risk for cortisol insufficiency in acute illness and stress, because of immaturity of the adrenal gland. The adrenal neocortex generally does not synthesize cortisol until ~ 30/40. Before this, the fetus uses progesterone from the placenta to … Continue reading

Posted in Endocrine, Prematurity | Leave a comment