Congenital Hypothyroidism

Pt age < 1 month with uncomplicated perinatal history presents with poor feeding. Newborn screen shows elevated TSH, decreased T4. Hypothermia, jaundice on exam.

• Confirm TSH, T4

• Refer for thyroid U/S

• Start levothyroxine immediately and refer to endocrinology

• Parents advised that prognosis is excellent with treatment but that failure to f/u could result in permanent neurologic deficits