Determinación de la Hormona Estimulante de la Tiroides (Tsh) y su relación con la Bilirrubina en Recién Nacidos con Ictericia

Abstract

Jaundice is a yellowing of the skin and mucous membranes caused by the impregnation of bilirubin in the skin. Too much bilirubin is called hyperbilirubinemia in the newborn can cause brain damage called kernicterus. The thyroid is a gland located in the front of the neck, responsible for the secretion of thyroid hormones, thyroxine or T4, and triiodothyronine or T3. These hormones regulate important aspects of growth, development and functions of cells, organs and systems, metabolism of the heart, digestive tract and reproductive system, including neurons in the brain, these are affected when you do not have adequate levels. The main objective of the research is to determine the values of Thyroid Stimulating Hormone (TSH), free thyroxine values (FT4) and bilirubin in newborns with jaundice. An observational, descriptive, experimental and field research was conducted in the Department of Neonatology Provincial General Hospital in Latacunga October 2015 to March 2016. The enzymatic method was used for the determination of bilirubin and for determination of TSH and FT4 Immunoassay electrochemiluminescence "ECLIA" was used. The sample consisted of 50 newborns with jaundice who were in the area of neonatology Provincial General Hospital in Latacunga. Newborns may have jaundice when total bilirubin levels reach higher figures than 2.5 mg / dL and usually have two types of jaundice. Physiologic jaundice appears after 24 hours old, poses no harm to the newborn but is used as heliotherapy treatment is the use of sunlight. Pathological jaundice appears in the first 24 hours after birth, the newborn should receive immediate treatment to prevent severe damage. In the research we had 39 newborns who had physiological jaundice corresponding to 78% and 11 newborns had jaundice pathological corresponding to 22%. Infants who have low levels of Thyroid Stimulating Hormone (TSH) and high or normal levels of free thyroxine (FT4) tell us that the thyroid produces too much thyroid hormone and cause hyperthyroidism and newborns who have high levels TSH and low or normal FT4 values we indicate that the thyroid gland is not working properly and does not produce enough thyroid hormone and cause hypothyroidism. In research had 43 infants who had a normal diagnosis corresponding to 86%, 5 infants had a diagnosis of hypothyroidism is 10% and 2 newborns had a diagnosis of hyperthyroidism corresponding to 4%. Treatment for hypothyroidism should be administered levothyroxine and if you have hyperthyroidism is administered propranolol in the acute phase to reduce clinical symptoms or also radioactive iodine you get the same results but because of the risk of leukemia and cancer rarely used in pediatrics. In some cases surgical treatment is necessary.