Endocrine Abstracts

Introduction: Neonatal thyroid screening commenced in the UK in 1981. The TSH cut off point cut off point has changed from 80 mu/l to 25 mu/l over the period for early detection and referral. From April 2006 in the West midland this has dropped to 20 mu/l as upper level and 10 mu/l as lower level.

Method: Retrospective audit was undertaken in our hospital on babies referred with an abnormal Guthrie test for a period of 13 years from April 1996 to April 2009. Results were compared between 1996–2006 and 2006–2009 to see the impact on the change in Guthrie TSH levels.

Results: There were 20 cases referred in 10-year period during 1996–2006, and 18 cases in 3-year period, during 2006–2009. Lowering upper cut off point from 25 to 20 μ/l picked up 4 additional cases.

Four cases were picked up by lower cut off point (>10 μ/l), could have been picked up by the previous lower cut off point (>13 μ/l) as all the values were above 13 μ/l. 3/18 cases (17%) have not required treatment but needed regular monitoring and follow-up.

Conclusion: Number of referrals has increased from 2 cases per year during 1996–2006 to 6 cases per year during 2006–2009.

4/18 cases (22%) were picked up by lowering high cut off point, but lowering the lower cut off point has not picked up any additional cases.

There has been an increase in patient referrals and clinical workload following the change in recent TSH guidance.