Abstract
Background: Congenital hypothyroidism is well known cause of prolonged unconjugated hyperbilirubinemia and appears to be associated with the delayed maturation of hepatic uridine diphosphate glucoronyl transferase enzyme activity.
 Methods: This is a prospective, longitudinal and randomized study 100 babies are taken consisting of all newborn, age less than 28 days, admitted to hospital with exaggerated physiological jaundice.
 Results: One case of congenital hypothyroidism in exaggerated jaundice based on raised TSH levels. Rest of the cases (99%) having normal TSH levels. One case (1%) having TSH level of 48µu/ml on D7 of life indicating congenital hypothyroidism. TSB of this baby is 21.3 mg%. One baby is having TSH level of 30.4µu/ml on D3 of life which subsequently decreased to normal physiological limits on D7 of life.
 Conclusion: Though the present study is unable to make significant correlation between cause and effect relationship of neonatal exaggerated jaundice and congenital hypothyroidism, but as one case has diagnosed to be suffering from congenital hypothyroidism, TSH should be considered as a screening test for all babies suffering from exaggerated physiological jaundice besides the other predisposing factors responsible for causation of hypothyroidism.
 Keywords: Neonatal hyperbilirubinemia, Preterm, Congenital hypothyroidism
Highlights
Neonatal hyperbilirubinemia is an important problem in the first week of life[1]
One case (1%) having TSH level of 48μu/ml on D7 of life indicating congenital hypothyroidism
Though the present study is unable to make significant correlation between cause and effect relationship of neonatal exaggerated jaundice and congenital hypothyroidism, but as one case has diagnosed to be suffering from congenital hypothyroidism, TSH should be considered as a screening test for all babies suffering from exaggerated physiological jaundice besides the other predisposing factors responsible for causation of hypothyroidism
Summary
Neonatal hyperbilirubinemia is an important problem in the first week of life[1]. In approximately 60% of term and 80% of preterm infants[2], Jaundice being the most frequent reason of readmission in hospital in first week of life[3,4].Physiological jaundice usually appears between 24-72 hrs of life peaks at 4-5 days of life in term and at 7th day in preterm & disappears by 10-14 day of life[4].Congenital hypothyroidism is well known cause of prolonged unconjugated hyperbilirubinemia and appears to be associated with the delayed maturation of hepatic uridine diphosphate glucoronyl transferase enzyme activity[5,6].The high incidence of prolonged neonatal jaundice in infants with congenital hypothyroidism documented by Aakerran[12] and confirmed by christensier[7] require reemphasis.Since jaundice may be the first sign of congenital hypothysoidism[8], this possibility must be kept in mind in the investigation of any cause of jaundice in infancy. In approximately 60% of term and 80% of preterm infants[2], Jaundice being the most frequent reason of readmission in hospital in first week of life[3,4]. Results: One case of congenital hypothyroidism in exaggerated jaundice based on raised TSH levels. One case (1%) having TSH level of 48μu/ml on D7 of life indicating congenital hypothyroidism. One baby is having TSH level of 30.4μu/ml on D3 of life which subsequently decreased to normal physiological limits on D7 of life. Conclusion: Though the present study is unable to make significant correlation between cause and effect relationship of neonatal exaggerated jaundice and congenital hypothyroidism, but as one case has diagnosed to be suffering from congenital hypothyroidism, TSH should be considered as a screening test for all babies suffering from exaggerated physiological jaundice besides the other predisposing factors responsible for causation of hypothyroidism.
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