Hypothyroidism In Children - Congenital, Subclinical Hypothyroidism In Children

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Hypothyroidism in children

Hypothyroidism in children is a condition in which the thyroid gland produces hormones (thyroid), but there are too few of them. It develops when there are not enough of them to meet the normal needs of the body. It should be noted that the disease occurring in childhood is somewhat different from that in adults and leads to irreversible conditions more quickly. That is why, as soon as the baby is born, usually within the first two days, blood is taken from him to study the level of thyroid hormones, namely, screening of TSH, T4, antithyroid antibodies and thyroglobulin is done.

Moreover, only in the first weeks of intrauterine development, the mother's hormones act on the fetus, and starting from the 12th week, it produces its own thyroid hormones, since its own thyroid gland begins to function. Since their deficiency leads to mental and physical underdevelopment, hypothyroidism is given great attention in pediatrics. The younger the child, the more dangerous this disease is for him, and sometimes it can constitute a real risk of a threat to the health and even the life of the baby.

Hypothyroidism in children can be either congenital or acquired. As for the degree of severity, there is a transitional, subclinical and manifest deficiency in the production of thyroid-stimulating hormones. If we classify the disease by the level of hormone production disturbance, then we can distinguish 3 types: thyrogenic, pituitary and hypothalamic.

Content:

• Symptoms of hypothyroidism in children
• Congenital hypothyroidism in children
• Subclinical hypothyroidism in children

Symptoms of hypothyroidism in children

It should be understood that the symptoms of hypothyroidism in children differ from the manifestations of a similar disease in adults, among them the following signs can be distinguished:

• Endemic cretinism, deafness, muscle spasticity, skeletal deformity, dwarfism, underdevelopment of the gonads and mental retardation are observed in those babies who received less thyroid-stimulating hormones from their mother even in the early stages of her pregnancy. But most often in the first weeks of a child's life, hypothyroidism does not manifest itself in any way.
• A large birth weight, especially when the baby weighs more than 4 kilograms, swelling of the eyelids, tongue and face, as well as heavy breathing and rough crying - all these symptoms give doctors the opportunity to suspect hypothyroidism even before the hormone screening result comes.
• In some newborn babies, a long healing of the umbilical wound can be observed, as well as prolonged jaundice and a weak sucking reflex. Sometimes a baby has an umbilical hernia.

• General lethargy, drowsiness, and muscle weakness begin to appear later, when the child gets a little older. Moreover, the symptoms will not be too pronounced, provided that the baby is breastfed.
• Lagging in height and weight, as well as late healing of the fontanelle, delay in the timing of teething - all this should alert the pediatrician to the development of hypothyroidism.
• Almost always, children with this disease do not begin to hold their heads for a long time, sit, stand and roll over, that is, the skills are not well formed.
• Bradypsychia is a clear sign of hypothyroidism. This symptom is expressed in the fact that the child's emotions are scarce and uncolored. He practically does not show interest in the world around him: there is no humming, pronunciation of syllables and subsequently words. At the later stages of a child's development, he does not play independently, becomes closed and does not make contact.
• Damage to the heart muscle, the development of anemia, frequent constipation, pallor of the skin and low body temperature - all these are signs of hypothyroidism in children beyond infancy.
• Decreased immunity.

As for adolescent children, hypothyroidism is manifested by the following symptoms:

• Significant weight gain, up to obesity.
• Skeleton growth retardation.
• Late puberty.
• Abrupt mood swings, pronounced negative reactions.
• Decreased school performance as a result of slowing down thinking and attention.
• Hoarse voice.
• Rare pulse.
• Hair loss and dry skin.

Since hypothyroidism leads to rather serious problems, its timely diagnosis and competent treatment are necessary.

Congenital hypothyroidism in children

Congenital hypothyroidism in children is a decrease in the function of the thyroid gland and, as a result, insufficient production of thyroid-stimulating hormone in newborns. Girls are more likely to suffer from this than boys.

Congenital hypothyroidism does not occur on its own; a number of reasons lead to this condition:

• If the maturation of the thyroid gland, its growth and development at the stage when the fetus is in the mother's womb, is disturbed, then we can talk about hereditary reasons that led to the development of hypothyroidism.
• It happens that there is a lack of susceptibility to iodine of the thyroid gland itself, it happens that the "transportation" of substances necessary for the production of hormones is disrupted. All this will inevitably lead to hypothyroidism.
• There are even more severe endocrine diseases, they are associated with damage to a certain area in the brain that is responsible for regulating the production of hormones (hypothalamus).
• Resistance to thyroid hormones may also manifest itself and hypothyroidism may develop against this background. Not all children suffer from such problems, but only those whose mother took antithyroid drugs. This applies to the time when the woman was carrying the fetus.

It makes no sense to consider the symptoms of congenital hypothyroidism, since they are absolutely similar to any other signs of the disease. But parents, having heard such a diagnosis, should not panic, doctors are obliged to explain to them that if they immediately start therapy, the treatment will be very effective. At the same time, nothing will threaten the life and health of the baby. The most commonly prescribed drugs are levothyroxine sodium. The effect will be noticeable after a week of adequate therapy in reasonable doses.

In this case, a child with congenital hypothyroidism should be observed not only by a pediatrician, but also by a neurologist and endocrinologist. Delays in both mental and physical development can be avoided only in the case of complex efforts of all doctors and systematic monitoring of the little patient.

Subclinical hypothyroidism in children

Subclinical hypothyroidism in children occurs when the TSH level is predominant, while T4 remains normal. Like all other types of this disease, subclinical hypothyroidism occurs more often in girls. Moreover, in childhood, it responds well to treatment.

As a cause of subclinical hypothyroidism, autoimmune thyroiditis can be distinguished, when the destruction of thyroid cells occurs.

If subclinical hypothyroidism is detected in a timely manner, then after undergoing treatment, he will no longer need any therapy. Symptoms include the following: low body temperature, breast refusal, dry skin, swelling of the face and eyelids. This applies to newborns and infants.

But quite often, subclinical hypothyroidism is observed in older children. It can cause problems with bone growth and brain activity. A decrease in vision often occurs. As with any other type of hypothyroidism, thyroid hormones are prescribed for the subclinical type. In this case, the dose must be calculated individually. It is not worth starting the disease, since at the later stages of progression, it can significantly reduce the child's standard of living and lead to tangible problems in his development.

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.