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Evaluation and management of the child with hypothyroidism

Alexander K C Leung1, Alexander A C Leung2

  • 1Department of Pediatrics, The University of Calgary, and The Alberta Children's Hospital, #200, 233 - 16th Avenue NW, Calgary, AB, T2M 0H5, Canada. aleung@ucalgary.ca.

World Journal of Pediatrics : WJP
|February 9, 2019
PubMed

Insights

Early diagnosis and treatment of hypothyroidism are crucial for optimal neurocognitive and physical development in children. Prompt intervention with levothyroxine, especially in infants, improves outcomes and prevents long-term complications.

Area of Science:

  • Pediatric Endocrinology
  • Developmental Neuroscience

Background:

  • Thyroid hormones are essential for normal childhood growth and neurocognitive development.
  • Timely identification and management of hypothyroidism are critical for optimizing patient outcomes.

Purpose of the Study:

  • To review the importance of prompt diagnosis and treatment of hypothyroidism in children.
  • To highlight key aspects of congenital and acquired hypothyroidism management.

Main Methods:

  • A literature search was conducted using PubMed with the keyword "hypothyroidism".

Main Results:

  • Congenital hypothyroidism stems from thyroid dysgenesis (85%) or dyshormonogenesis (15%).
  • Newborn screening detects congenital hypothyroidism, often asymptomatic in infants.
  • Hashimoto thyroiditis and iodine deficiency are leading causes of acquired hypothyroidism globally.
  • Central hypothyroidism is rare and may link to other hormonal deficiencies.

Conclusions:

  • Initiate levothyroxine treatment within the first two weeks of life for congenital hypothyroidism to enhance neurocognitive outcomes.
  • Early treatment of acquired hypothyroidism is vital for normal growth, development, and cognitive function.
  • Therapeutic goals include maintaining serum TSH < 5 mIU/L and T4 levels in the upper half of the reference range, alongside symptom resolution.
Abstract

Keywords:
DysgenesisDyshormonogenesisHashimoto thyroiditisHypothyroidismIodine deficiencyLevothyroxineMental retardationStunted growth

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