The congenital hypothyroidism: the incidence and clinical features of different forms

T.V. Sorokman

Abstract


Background. Congenital hypothyroidism (CH) as the most common hereditary thyroid pathology is a serious social, economic and psychological burden for a family, where the sick child was born, as well as for the society. The purpose of our study was to evaluate the disease incidence and to detect the clinical features of various forms of congenital hypothyroidism in children. Materials and methods. Twenty two medical records of patients with CH (14 girls, 8 boys) aged 1 month to 6 years (experimental group) and 20 healthy children of the correspondent age were analyzed, and the further assessment of their physical and neuropsychological development was conducted. All children underwent the ultrasound examination of the neck region, indirect laryngoscopy; thyroid-stimulating hormone (TSH), thyroglobulin antibodies, free thyroxine (fT4), thyroglobulin tests were also performed. Clinical signs of CH in the neonatal period were estimated according to the Apgar scores. Statistical analysis was performed with the aid of the Statistica 6.0 program. Results. The thyroid dystopia was diagnosed in 59.1 % of cases, in particular: in the hyoid area (5), the root of the tongue (2), submandibular area (2), jugular fossa (1), unspecified (2). The median of TSH in the first stage of screening in children of the main group was 38 mU/l (24.2–122.4 mU/l), in the comparison group — 2.03 mU/l (1.7–2.6 mU/l). The fT4 level ranged from 0.49 to 14.7 pmol/l, on average — 2.37 pmol/l. The number of clinical signs was not dependent on the age neither on the form of hypothyroidism at the moment of diagnosis. With age, children’s development increasingly lags behind those of correspondent age contributing to further development of fine motor delay. In 40.9 % of patients with CH, the relatives suffered from thyroid disease. Conclusions. The thyroid dystopia is the most common among various forms of congenital hypothyroidism (59.1 %). The reliable differences in TSH and fT4 levels were not found in children with thyroid dystopia and those with typically located thyroid gland. The number of clinical signs was not dependent on the age neither on the form of hypothyroidism at the moment of diagnosis and varied from their absolute absence to presence of seven symptoms at the same time. A delayed formation of motor skills, emotional reactions, the components of cognitive activity was observed in children with congenital hypothyroidism. More than one-third of children with congenital hypothyroidism have concomitant somatic pathology. The predominant lesions of any organs and systems and dependence of the nature of comorbidity on the etiology of congenital hypothyroidism were not observed. In 13.6 % of children, the congenital malformations of other organs were found, mainly in patients with congenital hypothyroidism caused by thyroid dystopia.

Keywords


children; congenital hypothyroidism

References


Kaminskiy AV, Kovalenko AN, Teplaya EV. Problem of iodine deficiency in Ukraine: prevention in children, pregnant and adults. Mezhdunarodnyiy Endokrinologicheskiy Zhurnal. 2011;6(38):18-22. (In Russian).

Bruno De Benua, Shvets OV. Elimination of iodine deficiency is one of the key health problem. Mezhdunarodnyiy Endokrinologicheskiy Zhurnal. 2011;6(38):9-17. (In Russian).

Pardo Campos ML, Musso M, Keselman A, Gruñeiro L, Bergadá I, Chiesa A. Cognitive profiles of patients with early detected and treated congenital hypothyroidism. Arch Argent Pediatr. 2017;115(1):12-7. doi: 10.5546/aap.2017.eng.12.

Zhukov AO. Caused by the iodine deficiency delay of psychical development and syndrome of deficit of attention. Zhurnal nevrologii i psihiatrii. 2007;6:4-16. (In Russian).

Ford G, LaFranchi SH. Screening for congenital hypothyroidism: a worldwide view of strategies. Best Pract Res Clin Endocrinol Metab. 2014;28(2):175-87. doi: 10.1016/j.beem.2013.05.008.

Loeber JG. Neonatal screening in Europe; the situation in 2004. Journal of Inherited Metabolic Disease. 2007;30(4):430-438. doi: 10.1007/s10545-007-0644-5.

Bastug O, Korkmaz L, Halis H, Memur S, Korkut S, Ozdemir A, Gunes T, Ozturk MA, Kurtoglu S. Thyroid status of iodine deficient newborn infants living in central region of Turkey: a pilot study. World J Pediatr. 2017 Feb 14. doi: 10.1007/s12519-017-0017-6.

Parks JS, Lin M, Grosse SD, Hinton CF, Drummond-Borg M, Borgfeld L, et al. The impact of transient hypothyroidism on the increasing rate of congenital hypothyroidism in the United States. Pediatrics. 2010;125 Suppl 2:54-63. doi: 10.1542/peds.2009-1975F.

Hopfner S, Koehler N, Hopfner B, Rauterberg EW. Neonatal screening for congenital hypothyroidism in Germany. The development of concerned children in retrospect analysis using the federal state “Hessen”. Klin Pediatr. 2007;219(4):206-11. (In German). doi: 10.1055/s-2006-921579.

Nasirova UF. Influence of iodine deficiency on the thyroid gland and neuropsychological development of children with neonatal transient hypothyroidism. Problemyi endokrinologii. 2006;52(5):15-7. (In Russian).

Fagman H, Nilsson M. Morphogenetics of early thyroid development. Mol Endocrinol. 2011;46:33-42 doi: 10.1677/JME-10-0084J.

Zimmermann MB, Aeberli I, Andersson M, Assey V, Yorg JA, Jooste P, et al. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 µg/L: a UNICEF/ICCIDD study group report. J Clin Endocrinol Metab. 2013;98:1271-80 .doi: 10.1210/jc.2012-3952.

Kollati Y, Ambati RR, Reddy PN, Kumar NS, Patel RK, Dirisala VR. Congenital Hypothyroidism: Facts, Facets & Therapy. Curr Pharm Des. 2017 Feb 6. doi: 10.2174/1381612823666170206124255.

Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010 Jun 10;5:17. doi: 10.1186/1750-1172-5-17.

Peiris AN, Oh E, Diaz S. Psychiatric manifestations of thyroid disease. J South Med. 2007;100(8):773-4. doi: 10.1097/SMJ.0b013e3180f62916.




DOI: https://doi.org/10.22141/2224-0721.13.3.2017.104115

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