Initial evaluation of congenital hypothyroidism: a survey of general paediatricians in East Anglia
Department of Paediatrics,
University of Cambridge Clinical School, Addenbrooke's Hospital, Box
116, Hills Road, Cambridge CB2 2QQ
Correspondence to: Dr Ahmed.
Accepted 16 June 1997
The practice of general paediatricians in the initial
evaluation of congenital hypothyroidism (CHT) was assessed. This was performed by a questionnaire survey of paediatricians in East Anglia of
whom 84% responded. Nineteen of 25 clinicians based in seven district
hospitals managed children with CHT. The median number of children in
the care of each clinician was 4 (range 1-17) and the median number of
children attending each hospital was 12 (range 5-23). All except one
clinician arranged to confirm the diagnosis with a serum thyroid
stimulating hormone concentration and free or total thyroxine. There
was variation of opinion on the value of serum triiodothyronine and
free triiodothyronine measurements, antibody screening, knee
radiographs, and thyroid isotope scans. One clinician sought advice
when notified of new children and two expressed the need for an
investigation protocol. These findings indicate that most general
paediatricians in East Anglia manage only a few children with CHT; the
initial diagnosis is appropriately confirmed but they are uncertain
about the value of other investigations.
© 1997 by Archives of Disease in Childhood
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