Outcome of Congenitally Hypothyroid screening program in Isfahan; from prevention to treatment

Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH). Considering the high prevalence of CH in Isfahan, the aim of this study is to evaluate the outcome of treatment in CH patients, diagnosed during the screening program. In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September2009, were studied.Frequent visits were performed in CH patients to monitor and follow their treatment. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference range. From 225224 screened neonates, 536 of them were diagnosed as CH patients. The prevalence of CH was 1/420 alive birth. Mean age at starting treatment was 22.9 ± 13.2 days. In 93.7 % of patients treatment was began before 45th day of life. In the first measurement after initiating treatment T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respetively. Mean of T4 and TSH had reached to normal range during treatment. T4 had reached the normal range earlier than TSH. The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatment are crurical for optimal treatment, specially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.