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Laboratory test results are the only reliable means of diagnosing congenital hypothyroidism in the newborn infant.In order to optimize the results of the neonatal screening test, causes of failure have to be recognized. 

They can be divided into two main categories:technical errors and patients who had normal values at the time of the screening "Delayed TSH rise".

Together they account for 3:100,000 newborns, that is 1:8 diagnosed babies.

Thus, the pediatrician must be alert to the presence of signs and symptoms of the disease even if diagnosis of the hypothyroidism has not been made by screening test.