You are the intern in a newborn follow-up clinic. A 9-day-old boy has been recalled because his newborn bloods…

Question

You are the intern in a newborn follow-up clinic. A 9-day-old boy has been recalled because his newborn bloodspot screening result shows a markedly raised thyroid-stimulating hormone. He was born at term, is breastfeeding well and has regained his birth weight. There is no goitre, no umbilical hernia, no prolonged jaundice and his tone and cry are normal. His parents are frightened and want to know what happens now. Which one of the following is the most appropriate management?

Accepted Answer

Start levothyroxine today, taking venous blood first.

Answer

Arrange a thyroid radionuclide scan first.

Answer

Repeat the bloodspot card in one week.

Answer

Start levothyroxine after the venous result returns.

Answer

Start levothyroxine when clinical features appear.

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