[Detection of congenital hypothyroidism in 26,282 newborn infants].
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Biomedical subjects
Publications and source records attributed to R Scholler.
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The evolution of 50 hydatidiform moles was followed through repeated radioimmunoassays of choriogonadotropin (hCG), either in urine or plasma. In 37 cases a spontaneous regular decrease was observed, but it generally slowed down after the first week. In fact, only 30% of the total number of moles examined cleared up spontaneously within a month and 54% within 8 weeks. In 12 cases a diagnosis of retention of trophoblastic tissue was made: three times during the first month of evolution on the basis of a stagnation of the decreasing curve. In the 9 cases without radioimmunoassay of hCG between the 10th and 40th days after evacuation, the diagnosis was not made until after two months. The specific assay of hCG with an anti beta-hCG antiserum enables the resolution of diagnostic problems raised by the cross-reaction of hypopituitary LH when using the classic antiserum and particularly the differential diagnosis between the retention of trophoblastic tissue and a beginning pregnancy immediately following a mole, or a high level of LH after castration.
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An analysis of 100 cases detected at the age of 19 years during selection for National Service. A somatic, genetic, psychological and hormonal profile emerges from this homogeneous sample. A study of olfactory function and insulin secretion was made. Testosterone deficiency was moderate, DHT deficiency being much more marked and insensitive to stimulation, suggestive of a 5 alpha-reductase defect. Impairment of oestrogenic function of the testis was demonstrated.
Secretion of choriogonadotropin (hCG) remains until now the more accurate biochemical label of trophoblastic disease and a close follow-up is possible by means of sensitive and specific radioimmunoassays. After hydatidiform moles, drawing the decreasing curve of hCG concentrations by weekly measurements in plasma or urine, would generally allow distinguishing within a few weeks cases with and without retention of active trophoblastic tissue, although in only 30 p. 100 of moles hCG spontaneously disappears within a month. In some choriocarcinoma under therapy, low persisting hCG levels (lower than 100 or 50 I.U./24 hours) could only be evidenced by repeated radioimmunoassays. Even with apparently physiological hLH/hCG concentrations, the use of anti-beta hCG antiserum could demonstrate, if any, a secretion of choriogonadotropin. In castrated women the same technique would elude the interference of hLH and make easier the diagnostic of relapses.
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