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先天性甲状腺機能低下症の発見と治療_ Detection and treatment of congenital hypothyroidism

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2011年11月05日(Sat) 06:07 by drharasho

先天性甲状腺機能低下症に関する最新の総説論文です。
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Nat Rev Endocrinol.
2011 Oct 18. doi: 10.1038/nrendo.2011.160. [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/22009163

Detection and treatment of congenital hypothyroidism.
Grüters A, Krude H.
Source

Institute of Experimental Pediatric Endocrinology,
Charité Universitätsmedizin Berlin, Augustenburgerplatz 1, D-13353 Berlin, Germany.

Abstract

Congenital hypothyroidism is the most frequent endocrine disorder in neonates.
先天性甲状腺機能低下症は新生児に最もよくみられる内分泌疾患。

Controversy exists regarding the necessity to adjust current screening programs
to also diagnose patients with central hypothyroidism or those with mild forms
 of congenital hypothyroidism, who have high TSH levels but normal T(4) and
normal T(3) levels (also known as 'subclinical hypothyroidism').
中枢性甲状腺機能低下症と潜在性甲状腺機能低下症のスクリーニングが課題。

Thyroid hormone replacement should start as soon as the diagnosis is confirmed
by measurement of elevated TSH and low serum thyroid hormone levels.
Further diagnostic approaches, such as ultrasonography, scintigraphy and measurement
of thyroglobulin levels, to determine the subtype of congenital hypothyroidism,
should not delay initiation of treatment. Recommendations regarding
 the initial dosage of levothyroxine vary considerably, and no general
 accepted guideline exists with regards to initial dosage or optimal time
point for dose adjustment according to biochemical parameters. More than 30
 years after the introduction of the first neonatal screening programs,
mental retardation can be prevented in the majority of children (>90%)
with congenital hypothyroidism if therapy is commenced within the first 2 weeks
of life, making neonate screening for this disorder the most successful
population-based screening test in pediatrics.
生後2週間以内の治療開始が肝心。

PMID:22009163  [PubMed - as supplied by publisher]

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