Congenital hypothyroidism in children - is a chronic disease in which the thyroid activity disrupted newborn babies and reduced the amount of thyroid hormones in the blood.Why this happens in children, what are the signs and symptoms of congenital hypothyroidism, what is its danger, as well as than to treat it?We will tell you all about congenital hypothyroidism in children, which may help to understand its nature and how to deal with it.
1. Congenital hypothyroidism: the causes, signs and symptoms, diagnosis and treatment of disease
2. What is hypothyroidism in children?
3. What is the role of the thyroid gland in children's body?
4. Why do children get sick congenital hypothyroidism, what are its causes?
5. Symptoms and signs of the disease in newborns
6. Severe untreated illness - cretinism
7. diagnosis of congenital hypothyroidism in newborns
9. Basic principles of drug dosing "Levothyroxine"
• Congenital hypothyroidism: the causes, signs and symptoms, diagnosis and treatment of disease.
The causes of congenital hypothyroidism in children can serve a variety of factors: genetic mutations, infections, and so on.The main symptoms of congenital hypothyroidism, and with it and its consequences - is lagging behind children in physical and mental development, and later closing fontanelle a child, later tooth eruption, dry skin.
diagnosis of congenital hypothyroidism is carried out in absolutely all children, right in the maternity hospital for 3-4 days of life babies.Treatment of congenital hypothyroidism is performed with drugs which replace the thyroid hormones, which do not develop naturally, thyroid child.In the case of proper, timely treatment of babies diagnosed with hypothyroidism, further develop normally.Late start of treatment can lead to irreversible consequences - defects in development of the skeleton and nervous system baby.
• What is hypothyroidism in children?
Congenital hypothyroidism in children - a disease in which the reduced thyroid function in newborns.According to medical statistics hypothyroidism in children occurs in 1-2 cases per 5000 newborns.They are more prone to congenital hypothyroidism mainly girls (usually 2 times than boys, ill them).
• What is the role of the thyroid gland in children's body?
thyroid gland - an organ of the endocrine system of the human body.It is the "duty" to carry out these important functions for normal development and life of a child:
- 1. Control the basic metabolism and body temperature.
- 2. Regulation of the exchange of fats, proteins and carbohydrates in the body.
- 3. Regulation of calcium metabolism.
- 4. Participation in the formation of intelligence.
in childhood thyroid promotes growth and normal, harmonious development of the entire body as a whole baby.Most thyroid plays an important role in the development of the skeleton and nervous system of the baby.Thyroid hormone is produced by two types, namely: hormones thyroxine (T4) and triiodothyronine hormone (T3).
In the case of congenital hypothyroidism is reduced secretion of hormones by the thyroid gland, but because there is a shortage of them in the body.The lack of thyroid hormones, hypothyroidism observed in children, can cause a strong inhibition of the physical and mental development of the child.
• Why do children get sick congenital hypothyroidism, what are its causes?
of congenital hypothyroidism can be due to various reasons, the main ones are the following:
- 1. Heredity.Congenital hypothyroidism and genetics are closely related, in most cases some genetic mutations provoke the development of congenital hypothyroidism due to thyroid disorders even before the formation of the child's birth (in utero).
- 2. Disturbances of hormones (thyroid cells decreased sensitivity to iodine, violation of transport of substances necessary for the synthesis of hormones, the metabolism of iodine).
- 3. The defeat of the hypothalamus (the so-called secondary hypothyroidism).Hypothalamus called the center of the nervous system that controls the thyroid and other endocrine glands of the human body.Lesions of the hypothalamus is often accompanied by severe endocrine disorders.
- 4. Decrease the sensitivity (resistance) to the thyroid hormones.As a rule, decreased sensitivity of body cells to thyroid hormone occurs as a result of receiving the child's mother antithyroid drugs during gestation baby (for example, if a pregnant woman is sick goiter).
• Congenital hypothyroidism: the symptoms and signs of congenital hypothyroidism in newborns
Symptoms of congenital hypothyroidism often do not manifest themselves in the first weeks of life baby, they begin to appear only after a few months, but then the parents,and doctors say a clear lag in the development of the baby.Only a small proportion of children, symptoms of congenital hypothyroidism in the first weeks of life.
most common in the early days of a child's life signs of congenital hypothyroidism - is:
- 1. Big weight birth weight (greater than 3500 m.).
- 2. half-open mouth.
- 3. Dropsical face.
- 4. Swelling in supraclavicular fossa in the form of dense "cushions".
- 5. gruff voice while crying.
- 6. Prolonged jaundice.
- 7. nasolabial triangle cyanosis (cyanosis).
Typical symptoms of congenital hypothyroidism 3-4 months of age - is:
- 1. Decreased appetite.
- 2. peeling skin.
- 3. Chronic constipation.
- 4. Reduced body temperature.
- 5. Brittle hair in the baby.
In the later stages of the characteristic features of hypothyroidism are as follows:
- 1. Later teething.
- 2. Delayed physical development.
- 3. mental retardation.
It is worth noting the fact that identify congenital hypothyroidism in the first days of the child's life rarely works, only on the grounds of his symptoms.Much more successful copes with this task early screening of children for congenital hypothyroidism, which is carried out in the hospital for all infants.Early detection of the disease (in terms of the first 3-4 weeks) and the beginning of the treatment is of great importance to was a normal child growth and development in the future.The lack of thyroid hormones in the early life of a child can lead to irreversible pathologies of the nervous system.That is why the treatment of congenital hypothyroidism in children should start no later than a month after the child's birth.
• Severe untreated illness - cretinism
Nowadays, fortunately, most children with hypothyroidism receive the necessary treatment in time, compensate for the lack of hormones that must produce imperfect thyroid.In the absence of treatment, the baby develops a pronounced lag of physical and intellectual development - cretinism.The signs of cretinism are short stature, deformed face, twisted limbs, a low level of intellectual development, the tendency to the development of various chronic diseases.
• Diagnosis of congenital hypothyroidism in newborns
diagnosis of congenital hypothyroidism in children is carried out using the Apgar score.Actually this is a test that summarizes points, if certain features:
Suspect congenital hypothyroidism should be when the total amount of more than 5 points.
diagnose possible time thanks to holding early newborn screening - screening.Hypothyroidism first screening was carried out in 1971 in Canada.
known that the disease is characterized by low levels of thyroid hormones in the blood while increasing the content of thyroid stimulating hormone (TSH) in the blood - the hormone of the hypothalamus, which stimulates the thyroid gland.The main objective of screening - is to identify infants who have elevated levels of TSH.
Generally, for the diagnosis of hypothyroidism in newborns 3-4 days the child's life is taken from the blood of his heels.By determining the amount of blood sample hormone (TSH) in the blood.The concentration of TSH exceeding 50 mU / l gives reason to suspect hypothyroidism in children.
This analysis takes several weeks.At the same time the analysis report only the parents who have kids with suspected hypothyroidism.The rest of the results are not reported.
• Congenital hypothyroidism: treatment
Provided time started the correct treatment of congenital hypothyroidism mental and physical development of children is proceeding normally.Treatment should be initiated as soon as the diagnosis.The main method of treatment of this disease in children is based on replacement therapy with levothyroxine sodium (L-thyroxine, tyrosine-4 Eutiroks, L-thyroxine-Farmak, L-thyroxine-acre).
Information about the treatment of congenital hypothyroidism is provided for informational purposes only.Prescribe drugs and should only endocrinologist!
«Levothyroxine" in small doses has anabolic effect, ie contributing to the formation of the necessary materials and the growth of the child's body.With regard to medium-dose "levothyroxine" they contribute to the development and growth of the organism, increase tissue oxygen demand, influence the metabolism of carbohydrates, proteins and fats in the body of the child.The positive effects can be seen literally at 7-12 days after the start of treatment.
In developed countries, treatment is usually begin no later than the first month of baby's life (in England - 10-15 th day of life in Germany - on the 7-8th day).
Preparation "Levothyroxine" in a chemical structure similar to that of thyroid hormone thyroxine that it is the main advantage in comparison with other drugs.
After taking the drug, "Levothyroxine" baby body creates a certain concentration of the drug consumed them as needed.Thus, it is possible to avoid high levels of the hormone.The daily dose in congenital hypothyroidism is given to the child in the morning an hour before breakfast, with a small amount of water.Kids in their first weeks of life should be prescribed the drug during the morning feeding babies.
criteria for adequate treatment of congenital hypothyroidism in children with this drug act:
- 1. Normal levels of serum TSH in children's blood.
- 2. Indicators of thyroxine in children first year of life.Test to determine its concentration should be performed every 2-3 months during the first year of life, and every 3-4 months after 1 year.
- 3. Growth of the skeleton.
- 4. Dynamic Data mental development of the baby.
- 5. The data of the physical dynamics of the different periods in the life of the baby.
thyroxine level in children's blood in congenital hypothyroidism is usually normal after 10-14 days after the start of treatment.As for the level of TSH, after the start of treatment It normalizes the child within 2-3 weeks.
dosage of levothyroxine sodium is selected for each child individually, taking into account the laboratory and clinical evidence of his condition.The drug is available in varying doses - namely 25, 50 and 100 mg of the drug per tablet.Parents should know the medications prescribed dose in mg, not only in some parts of the tablet.As for the baby the same negative consequences and can have the disadvantage and drug overdose.
• Basic principles of drug dosing "Levothyroxine."
To treat congenital hypothyroidism in the first weeks of life (per 1 square meter of body surface), the dosage is:
- 1. initial dose - 12.5-50 mg / day.
- 2. maintenance dose - 100-150 mg.
- 3. Children with congenital hypothyroidism to 6 months of age: 8-10 mg / kg / day.
- 4. Children with congenital hypothyroidism to 6-12 months of age: 6-8 mg / kg / day.
- 5. Children with Congenital hypothyroidism up to 5 years of age: 5-6 mg / kg / day.
- 6. Children with congenital hypothyroidism in 6-12 years of age: 4-5 mg / kg / day.
therapy is performed only by a physician, endocrinologist, but the observation of the decks with congenital hypothyroidism carried endocrinologist, a pediatrician and neurologist.
If proper and timely treatment of babies with hypothyroidism grow and develop well.Therefore, it is important to recognize the start and well to treatment.
Congenital hypothyroidism, Komorowski, a video of the newborn: