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November 1988

The Role of Imaging in Neonatal Hypothyroidism

Author Affiliations

Beth Israel Medical Center Departments of Pediatrics and Radiology First Avenue at 16th Street New York, NY 10003

Am J Dis Child. 1988;142(11):1139. doi:10.1001/archpedi.1988.02150110017005

Sir.—We read with much interest the report on congenital transient hypothyroidism and the role of transplacental thyrotropin (TSH)-blocking antibodies that appeared in the October 1987 issue of AJDC.1 Drs Francis and Riley are to be commended for their clear presentation of a rapidly evolving clinical topic, which has attracted the attention of physicians from such diverse specialities as pediatrics, endocrinology, clinical pathology, immunology, and diagnostic imaging. As practitioners of three of these specialties, we found the review comprehensive and informative but we disagree with their view that "the thyroid scan is of limited value in evaluation of transient neonatal hypothyroidism." We routinely image the neck sonographically to distinguish athyreosis from other forms of congenital hypothyroidism. In the absence of sonographically visible thyroid tissue in the neck, a technetium scan will clearly localize an ectopic gland. With tissue visualized on sonogram, the scintigram will distinguish an enzyme defect from

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