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Information about current guideline
The European Society for Paediatric Endocrinology (ESPE) published this guideline in January 2014. Its aim is to provide evidence-based recommendations for ‘optimal screening, prompt diagnosis, and adequate treatment’ of congenital hypothyroidism (CH).1 The guideline was formulated by a panel of experts from the ESPE and invited paediatric endocrinologist colleagues from around the world.
In 2013, the UK Newborn Screening Programme Centre, together with the UK Screening Laboratories Network and the British Society for Paediatric Endocrinology and Diabetes (BSPED), produced ‘Congenital Hypothyroidism: Initial Clinical Referral Standards and Guidelines’.2 This outlined the screening protocol nationwide, including thresholds for diagnosis, referral and recommendations for treatment. This guideline is particularly relevant to UK paediatricians given its reference to national screening policies and configuration of child health services. For example, it recommends that CH management be the responsibility of a paediatric endocrinologist or other lead paediatrician with appropriate experience. There are also national guidelines for CH screening in preterm infants (see box 1 for resources).
Leger et al.1
UK information for parents:
UK standards and guidelines
UK guidelines for preterm infants
ESPE and the American Academy of Pediatrics have also published previous guidelines. Nevertheless, considerable variations in practice persist worldwide, spurring the development of this guideline.3–5 Indeed, an audit of UK practice found marked variation, particularly around treatment and follow-up arrangements.6
Key issues addressed in this guideline
Neonatal screening: primary CH is best detected by determination of thyroid stimulating hormone (TSH) concentration, either on dried blood spot or venous sampling. Second screening of those in whom TSH may be suppressed initially, including preterm and unwell neonates, or those with a low birth weight, should be arranged before discharge from hospital. The BSPED 2012 guideline on CH screening in preterms recommends that for infants born <32 weeks …
Contributors HJ drafted the initial manuscript. CP amended it and provided expert opinion. HJ is an Academic Clinical Fellow funded by the NIHR.
Competing interests None.
Provenance and peer review Commissioned; externally peer reviewed.