Introduction: Screening program of congenital hypothyroidism is one of crucial evaluation in newborn period, because early detection and prompt treatment can prevent mental retardation. This screening is quite simple, and the result was revealed quickly. Beside devastating effect to central nervous system, undiagnosed congenital hypothyroidism also affect skeleton and bone maturation. Hypothyroidism constitutes about 25-30% cases of short stature in the developing nations. Case: A 6 years-old female referred to the Sanglah General Hospital in December 2021 with short stature and delayed milestone of development. She cannot walk and talk like normal children in her age. Patient performed thyroid profile and it suggest hypothyroidism with low FT4 0,42 ng/dL and high level of TSH 119,79 IU/ml. Bone age revealed delayed in bone maturation according to girls 8 months age. Patient got levothyroxine with dosage 12 mcg/kg/day (100 mcg/day) in December 2021. After one months of treatment, thyroid profile showed improvement TSHs still above normal 16,36, FT4 was normal 0,78. Conclusion: There is still cases of delay diagnosis and treatment of CH in developing country due to lack of screening program in newborn, low parental education level which led to devastating outcome for neuro muscular development.
| Published in | American Journal of Pediatrics (Volume 8, Issue 3) |
| DOI | 10.11648/j.ajp.20220803.16 |
| Page(s) | 181-184 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Late Diagnosis, Congenital Hypothyroid, Outcome
| [1] | Kurniawan LB. Congenital Hypothyroidism: Incidence, Etiology and Laboratory Screening. Indones J Clinical Pathol Med Laboratory. 2020; 26 (3): 375 – 80. doi: https://dx.doi.org/10.24293/ijcpml.v26i3.1527 |
| [2] | Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010; 10; 5: 17. doi: https://doi.org/10.1186/1750-1172-5-17 |
| [3] | Chowdhury SP, Sarkar TK, Haldar D, Taraphdar P, Naskar TK, Sarkar GN. Short stature in children: Experience from a tertiary care hospital in Kolkata, India. The health. 2011; 2: 139 42. |
| [4] | Ranke MB, Schwarze CP, Mohnike K, von Mühlendahl KE, Keller E, Willgerodt H, et al. Catch up growth after childhood onset substitution in primary hypothyroidism: Is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency. Horm Res. 1998; 50: 264 70. doi: 10.1159/000023288. |
| [5] | Malik BA, Butt MA. Is delayed diagnosis of hypothyroidism still a problem in Faisalabad, Pakistan. J Pak Med Assoc. 2008; 58: 545-9. |
| [6] | Hamid F, Islam R., Paul N, Nusrat N. Congenital Hypothyroidism: A Severely Neglected Case Report in Bangladesh. Bangladesh Medical Journal. 2014; 41 (1): 59–61. https://doi.org/10.3329/bmj.v41i1.18787 |
| [7] | Pulungan AB, Annisa D. 2019. Permasalahan dalam skrining hipotiroid. Prosiding 7th Indonesian Pediatric Endocrinology Update. Semarang. |
| [8] | Jacobsen BB, Brandt NJ. Congenital hypothyroidism in Denmark. Arch Dis Child. 1981; 56: 134-6. doi: 10.1136/adc.56.2.134. |
| [9] | Tarim OF, Yordam N. Congenital hypothyroidism in Turkey: a retrospective evaluation of 1,000 cases. Turk J Pediatr. 1992; 34: 197-202. |
| [10] | Ihsan I, Rini E. Delayed diagnosis of congenital hypothyroidism in an adolescent result in avoidable complications: a case report. PI. 2017; 57 (2): 108-6. doi: 10.14238/pi57.2.2017.108-16. |
| [11] | Ehrlich RM. Thyroxine dose for congenital hypothyroidism. Clin Pediatr. 1995; 34 (10): 521–22. doi: 10.1177/000992289503401002. |
| [12] | Rovet J. Congenital hypothyroidism: treatment and outcome. Curr Opin Endocrinol. 2005; 12 (1): 42–52. doi: 10.1186/1750-1172-5-17. |
| [13] | Alvarez M, Iglesias Fernandez C, Rodriguez Sanchez A, Dulin Lniguez E, Rodriguez Arnao MD. Episodes of overtreatment during the first six months in children with congenital hypothyroidism and their relationships with sustained attention and inhibitory control at school age. Horm Res Paediatr. 2010; 74 (2): 114–20. doi: 10.1159/000313370. |
| [14] | Rovet JF, Ehrlich R. Psychoeducational outcome in children with early-treated congenital hypothyroidism. Pediatrics. 2000; 105: 515–22. doi: 10.1159/000313370. |
| [15] | Oerbeck B, Sundet K, Kase BF, Heyerdahl S. Congenital hypothyroidism: influence of disease severity and L-thyroxine treatment on intellectual, motor, and school-associated outcomes in young adults. Pediatrics. 2003; 112: 923–930. doi: 10.1542/peds.112.4.923. |
| [16] | Kempers MJE, van der Sluijs Veer L, Nijhuis-van der Sanden RWG, et al. Neonatal screening for congenital hypothyroidism in The Netherlands: cognitive and motor outcome at 10 years of age. J Clin Endocrinol Metab. 2007; 92: 919–924. doi: 10.1210/jc.2006-1538. |
| [17] | Dimitropoulos A, Molinari L, Etter K, et al. Children with congenital hypothyroidism: long-term intellectual outcome after early high dose treatment. Pediatr Res. 2009; 65: 242–248. doi: 10.1203/PDR.0b013e31818d2030. |
| [18] | Rovet J. Long-term neuropsychological sequelae of early-treated congenital hypothyroidism: effects in adolescence. Acta Paediatr. 1999; 88: 88 –95. doi: 10.1111/j.1651-2227.1999.tb01168.x. |
| [19] | Bhattacharya A. Congenital hypothyroidism and developmental difficulties. Gen Med. 2013; 1: 1. doi: 10.4172/2327-5146.1000103. |
| [20] | Rochmah N, Faizi M, Dewanti C, Suryawan A. Pediatric quality of life in congenital hypothyroidism: an Indonesian study. Int J Thyroidol. 2020; 13 (2): 150-154. doi: 10.11106/ijt.2020.13.2.150. |
| [21] | Kandemir N, Yordam N. Height prognosis in children with late-diagnosed congenital hypothyroidism. Turk J Pediatr. 2001; 43 (4): 303-306. |
APA Style
Luh Putu Eka Sari Kresnandari, I Made Arimbawa, I Made Darma Yuda. (2022). Delayed Diagnosis of Congenital Hypothyroid: Concealed Problem in Developing Countries. American Journal of Pediatrics, 8(3), 181-184. https://doi.org/10.11648/j.ajp.20220803.16
ACS Style
Luh Putu Eka Sari Kresnandari; I Made Arimbawa; I Made Darma Yuda. Delayed Diagnosis of Congenital Hypothyroid: Concealed Problem in Developing Countries. Am. J. Pediatr. 2022, 8(3), 181-184. doi: 10.11648/j.ajp.20220803.16
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Download@article{10.11648/j.ajp.20220803.16,
author = {Luh Putu Eka Sari Kresnandari and I Made Arimbawa and I Made Darma Yuda},
title = {Delayed Diagnosis of Congenital Hypothyroid: Concealed Problem in Developing Countries},
journal = {American Journal of Pediatrics},
volume = {8},
number = {3},
pages = {181-184},
doi = {10.11648/j.ajp.20220803.16},
url = {https://doi.org/10.11648/j.ajp.20220803.16},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220803.16},
abstract = {Introduction: Screening program of congenital hypothyroidism is one of crucial evaluation in newborn period, because early detection and prompt treatment can prevent mental retardation. This screening is quite simple, and the result was revealed quickly. Beside devastating effect to central nervous system, undiagnosed congenital hypothyroidism also affect skeleton and bone maturation. Hypothyroidism constitutes about 25-30% cases of short stature in the developing nations. Case: A 6 years-old female referred to the Sanglah General Hospital in December 2021 with short stature and delayed milestone of development. She cannot walk and talk like normal children in her age. Patient performed thyroid profile and it suggest hypothyroidism with low FT4 0,42 ng/dL and high level of TSH 119,79 IU/ml. Bone age revealed delayed in bone maturation according to girls 8 months age. Patient got levothyroxine with dosage 12 mcg/kg/day (100 mcg/day) in December 2021. After one months of treatment, thyroid profile showed improvement TSHs still above normal 16,36, FT4 was normal 0,78. Conclusion: There is still cases of delay diagnosis and treatment of CH in developing country due to lack of screening program in newborn, low parental education level which led to devastating outcome for neuro muscular development.},
year = {2022}
}
TY - JOUR T1 - Delayed Diagnosis of Congenital Hypothyroid: Concealed Problem in Developing Countries AU - Luh Putu Eka Sari Kresnandari AU - I Made Arimbawa AU - I Made Darma Yuda Y1 - 2022/08/24 PY - 2022 N1 - https://doi.org/10.11648/j.ajp.20220803.16 DO - 10.11648/j.ajp.20220803.16 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 181 EP - 184 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20220803.16 AB - Introduction: Screening program of congenital hypothyroidism is one of crucial evaluation in newborn period, because early detection and prompt treatment can prevent mental retardation. This screening is quite simple, and the result was revealed quickly. Beside devastating effect to central nervous system, undiagnosed congenital hypothyroidism also affect skeleton and bone maturation. Hypothyroidism constitutes about 25-30% cases of short stature in the developing nations. Case: A 6 years-old female referred to the Sanglah General Hospital in December 2021 with short stature and delayed milestone of development. She cannot walk and talk like normal children in her age. Patient performed thyroid profile and it suggest hypothyroidism with low FT4 0,42 ng/dL and high level of TSH 119,79 IU/ml. Bone age revealed delayed in bone maturation according to girls 8 months age. Patient got levothyroxine with dosage 12 mcg/kg/day (100 mcg/day) in December 2021. After one months of treatment, thyroid profile showed improvement TSHs still above normal 16,36, FT4 was normal 0,78. Conclusion: There is still cases of delay diagnosis and treatment of CH in developing country due to lack of screening program in newborn, low parental education level which led to devastating outcome for neuro muscular development. VL - 8 IS - 3 ER -
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