CONGENITAL HYPOTHYROIDISM: CURRENT PERSPECTIVES

Sulfath Pottanpulan, He Bing Yan*, Blessy Joy 

ABSTRACT

Thyroid hormones are key essential factors for the development of the fetal and neonatal brain. A disease of the thyroid gland, congenital hypothyroidism occurs due to a partial or complete loss of function resulting in thyroid hormone deficiency. Present at birth, incidence of CH is gradually increasing worldwide, with an estimated prevalence of 1:2,000 to 1:4,000. This may be due to several factors like population ethnicity, varying screening programs and differing TSH cut-off values and environmental influences. It is also seen to affect more pre-terms and low birth weight new-borns than term neonates. It is one of the most common endocrine disorders in paediatric age group and if left untreated may result in growth failure and halted intellectual impairment. However, it still largely remains an underrated problem in many parts of the world due to lack of routine new born screening (NBS) programs. The aim of these programs include early detection of congenital hypothyroidism and an optimal neurocognitive outcome. American academy of paediatrics recommend treatment with levothyroxine (initial dose of 10-15μgm/kg/day) and this should be initiated within two weeks of life. The main aim of treatment is to normalize T4 levels within 2 weeks and TSH levels within one month and ensure positive growth and neurodevelopmental outcomes with no hindrance to their genetic potential. This article aims at the current outlook on congenital hypothyroidism and its management.

Keywords: Dyshormonogenesis, Dysgenesis, Levothyroxine, neonatal screening.