11.02.2014, 13:47
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Врач-участник форума
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Регистрация: 27.08.2009
Город: Саратов
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Европейский педиатрический гайд по врожденному гипотиреозу
European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism (J Clin Endocrinol Metab 99: 363–384, 2014) - [ Ссылки доступны только зарегистрированным пользователям ].
Процитирую пару разделов:
Цитата:
2.1 Biochemical criteria used in the decision to initiate treatment
• If capillary TSH concentration from blood obtained on neonatal screening is 40 mU/L whole blood, we recommend starting treatment as soon as a good venous sample can be obtained, without waiting for the venous blood test result, unless venous thyroid function test (TFT) results are available on the same day (1++0).
• If capillary TSH concentration is 40 mU/l of whole blood, the clinician may wait for the results of venous TFT, provided that these results are available on the following day (1++0).
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Цитата:
2.3 Decision to start treatment on the basis of venous TFTs
• If venous free T4 (FT4) concentration is below norms for age, treatment should be started immediately (1+++).
• If venous TSH concentration is > 20 mU/L, treatment should be started, even if FT4 concentration is normal (2++0).
• If venous TSH concentration is >6 to 20 mU/l beyond 21 days in a well baby with a FT4 concentration within the limits for age, we suggest
a) investigation, which should include diagnostic imaging, to try to obtain a definitive diagnosis;
b) consideration, in discussion with the family, of either initiating thyroxine supplementation immediately and retesting, off treatment, at a later stage; or withholding treatment but retesting two weeks later (2++0).
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