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Sylvie Hiéronimus Departments of Endocrinology, Diabetology and Reproductive Medicine

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Patricia Ferrari Departments of Biochemistry, University Hospital of Nice

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Jocelyn Gal Department of Biostatistics, University of Nice

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Frédéric Berthier Department of Biostatistics, University of Nice

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Stéphane Azoulay Institute of Chemistry, UMR 6001, University of Nice-Sophia-Antipolis

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André Bongain Gynaecology and Obstetrics, University Hospital of Nice

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Patrick Fénichel Departments of Endocrinology, Diabetology and Reproductive Medicine
Institut National de la Recherche Médicale, UMR U895, University Nice-Sophia-Antipolis, Nice, France

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Françoise Brucker-Davis Departments of Endocrinology, Diabetology and Reproductive Medicine
Institut National de la Recherche Médicale, UMR U895, University Nice-Sophia-Antipolis, Nice, France

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level [ 1 , 2 ], serum thyroglobulin (Tg) has been proposed as a marker of ID [ 3 ], including in newborns [ 4 , 5 ]. Maternal iodine supplementation has been shown to improve maternal and cord blood (CB) thyroid tests in areas of moderate and severe ID

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Selwan Khamisi Department of Endocrinology and Diabetes, Uppsala University, Uppsala, Sweden

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Peter Lindgren Women's and Children's Health, University Hospital, Uppsala University, Uppsala, Sweden

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F. Anders Karlsson Department of Endocrinology and Diabetes, Uppsala University, Uppsala, Sweden

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persisted, dyshormongenesis was suspected and an umbilical cord blood sample was drawn during GW 23. Analysis showed fetal hypothyroidism with TSH >100 mU/l (the sample was not further diluted; reference value 6.8 ± 2.9, mean ± SD [ 11 ]) and fT 4 3.8 pmol

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Camilo Fuentes Peña C Fuentes Peña, Nuclear Medicine, Hopital Erasme, Bruxelles, 1070, Belgium

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María Cecilia Opazo M Opazo, Instituto de Ciencias Naturales, Facultad de Medicina Veterinaria y Agronomía , Universidad de Las Americas, Santiago, Chile

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Luis Méndez L Méndez, Millennium Institute on Immunology and Immunotherapy, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile

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Claudia Riedel C Riedel, Millennium Institute on Immunology and Immunotherapy, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile

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Bernard Hauquier B Hauquier, Nuclear Medicine, Hopital Erasme, Bruxelles, Belgium

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Lionel Marcelis L Marcelis, Laboratory of Paediatric Research, Hopital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgium

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Frederic Cotton F Cotton, Clinical Chemestry - LHUB-ULB, Universite Libre de Bruxelles, Bruxelles, Belgium

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Rodrigo Moreno-Reyes R Moreno-Reyes, Nuclear Medicine, Hopital Erasme, Bruxelles, Belgium

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Background: Thyroglobulin (Tg) is a biomarker of iodine status. Newborn Tg is a more sensitive marker than neonatal TSH in detecting variations in iodine intake. This study aims to validate a Tg enzyme-linked immunosorbent assay (ELISA) for Tg determination on dried blood spots (DBS) in newborns. This study also set out to assess the stability of Tg and the influence of newborns’ hematocrit on Tg determination.

Methods: A commercially available ELISA Tg assay was adapted for use on DBS. DBS-Tg in cord blood were measured in 209 newborns delivered from healthy euthyroid pregnant women. Sensitivity, linearity, repeatability, and intermediate fidelity were determined using the appropriate standards and quality control materials.

Results: The limit of detection (LoD) of the DBS-Tg assay was 2.4 µg/L, and the limit of quantification (LoQ) was 5.8 µg/L. Repeatability and intermediate fidelity were 7.7-8.3% and 11.0-11.2%, respectively. The median cord plasma Tg and DBS-Tg values in newborns were not significantly different, 30.2 (21.3-44.4) µg/L and 31.6 (19.3-48.7) µg/L (p=0.48) with the ELISA respectively, and 76.5 (40.0-101.5) µg/L with the Elecsys assay with an R=0.88. DBS-Tg concentrations decrease with increasing hematocrit values (p<0.05). DBS-Tg values were stable at a concentration of 25 µg/L for 12 months at -20ºC and 4ºC.

Conclusion: This DBS-Tg assay demonstrated good analytical performances over a wide range of Tg concentrations, suggesting it is well suited to detecting variations in Tg concentrations. Studies comparing populations with different prevalence of anemia should consider the effect of hematocrit on DBS-Tg determination. The availability of a DBS-Tg assay for newborns makes it possible to integrate iodine status monitoring with newborn screening for inherited metabolic diseases.

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Hiroyuki Iwaki Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Kenji Ohba Medical Education Center, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Eisaku Okada Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takeshi Murakoshi Obstetrics and Gynecology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Yumiko Kashiwabara Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Chiga Hayashi Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Akio Matsushita Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Shigekazu Sasaki Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takafumi Suda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Yutaka Oki Department of Metabolism and Endocrinology, Hamamatsu-Kita Hospital, Hamamatsu, Japan

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Rieko Gemma Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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-dependent influence of ATDs on the difference in FT4 levels between maternal and cord blood in patients with Graves’ disease (GD) [ 2 , 9 ]. In this connection, future research proposed by the ATA guidelines task force includes a trial assessing the optimal target FT

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Mustafa Dinc Department of Internal Medicine, Beytepe Military Hospital

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Mustafa Cakar Departments of Internal Medicine, Ankara, Turkey

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Sevket Balta Cardiology, Gulhane Medical Academy, Ankara, Turkey

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Muharrem Akhan Departments of Internal Medicine, Ankara, Turkey

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Hakan Sarlak Departments of Internal Medicine, Ankara, Turkey

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Sait Demirkol Cardiology, Gulhane Medical Academy, Ankara, Turkey

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Dear Editor, We read the article ‘Relative impact of iodine supplementation and maternal smoking on cord blood thyroglobulin in pregnant women with normal thyroid function' by Hiéronimus et al. [ 1 ] with great interest. The authors

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Sylvie Hiéronimus Department of Endocrinology, Diabetology and Reproductive Medicine, University Hospital of Nice

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Françoise Brucker-Davis Department of Endocrinology, Diabetology and Reproductive Medicine, University Hospital of Nice
Institut National de la Recherche Médicale, UMR U895, University Nice-Sophia-Antipolis, Nice, France

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iodine supplementation and maternal smoking on cord blood thyroglobulin in pregnant women with normal thyroid function. Eur Thyroid J 2012;1:264-273. 10.1159/000342915 3 Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R

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Zhen Gao The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Hongtao Zhang The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Lijuan Zhang The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Huimin Yu The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Xuemin Di The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Zeyang Wang The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Zezhou Liu The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Aixia Sui The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Juan Wang The First Department of Oncology, Hebei General Hospital, Shijiazhuang, China

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Gaofeng Shi Department of Radiology, The 4th Affiliated Hospital of Hebei Medical University, Shijiazhuang, China

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Gy over a period 30 days. D max (the maximum dose) of the spinal cord and left intervertebral vessel and D mean (the mean dose) of the larynx and hypopharynx were mainly considered. The equivalent dose for a 2-Gy fraction schedule was calculated

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Zohar Steinberg Ben-Zeev Pediatric Department A, Ha’Emek Medical Center, Afula, Israel

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Marina Peniakov Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Clari Felszer Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Scott A Weiner Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Avishay Lahad Pediatric Department A, Ha’Emek Medical Center, Afula, Israel

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Shlomo Almashanu The National Newborn Screening Program, Ministry of Health, Tel Hashomer, Ramat Gan, Israel

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Yardena Tenenbaum Rakover Consulting Medicine in Pediatric Endocrinology, Clalit Health Services, Afula, Israel
The Rappaport Faculty of Medicine, Technion, Institute of Technology, Haifa, Israel

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recommended that in cases of high maternal TSI (≥3.7 times the upper reference limit), or when results are not available, umbilical cord blood be taken for TSI, TSH and FT4 determinations and the infant be examined for signs of hyperthyroidism ( 2 , 14

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Rania Mehanna Departments of Otolaryngology, South Infirmary Victory University Hospital, Cork, Ireland

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Matthew S. Murphy Endocrinology, South Infirmary Victory University Hospital, Cork, Ireland

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Patrick Sheahan Departments of Otolaryngology, South Infirmary Victory University Hospital, Cork, Ireland

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of their blood supply. On retraction of the thyroid lobe medially, the TZ, if present, is identified. The TZ is mobilized by dividing vascular and fibrous tissue at its apex (laterally) and along the superior and inferior borders. The TZ is then

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Antonis Polymeris Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Christina Kogia Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Dimitrios Ioannidis Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Dimitrios Lilis Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Maria Drakou Department of Endocrinology, Metabolism and Diabetes Mellitus/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Nicoletta Maounis Department of Cytology/Sismanogleio-Amalia Fleming Hospital, Athens, Greece

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Loukas Kaklamanis Department of Pathology/Mediterraneo Hospital, Glyfada, Greece

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Sofia Tseleni-Balafouta First Department of Pathology/University of Athens, Medical School, Athens, Greece

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Introduction Excessively increased levels of white blood cells (WBC), especially neutrophils, typically guide the diagnosis towards severe acute infection, inflammation, or myeloproliferative neoplasms (MPNs). However, in patients with

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