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Abstract
Background:
Congenital hypothyroidism (CH) is defined as thyroid hormone deficiency present at birth. Congenital hypothyroidism is a disease in which screening is beneficial, because mental retardation is prevented in 85% of these children.
Objectives:
1. To identify the etiology and common clinical features of congenital hypothyroidism in children.
2. To correlate the clinical features and T3, T4,TSH values with ultrasound and Technetium scan findings.
3. To find out the male:female ratio
4. To compare the sensitivity and specificity of ultrasound neck and Technetium scan.
Methodology:
It is a hospital based prospective study conducted in Department of Paediatrics, A J Institute of Medical Sciences, Mangalore. Study period was from November 2009 to October 2011. All those children above 3 yrs of age who were diagnosed to have hypothyroidism below 1 yr of age, on thyroxine, were advised to stop thyroxine for a period of 4 weeks and all newly detected cases of hypothyroidism below 1 yr of age were subjected for thyroid function test. All children with decreased thyroid function were subjected to an ultrasound neck and Technetium scan.
Results:
The study included 30 children with congenital hypothyroidism. . The female :male ratio is 1.3:1. Constipation was the most predominant clinical feature followed by umbilical hernia. Speech delay and feeding difficulty was observed in 20% each. 20% of the children had developmental delay. TSH was found to be high in all patients while T3 and T4 were decreased in majority of the patients (70% - 80%). In 63% of the patients thyroid was not visualized on doing ultrasound neck .Technetium scan detected 43.3% ectopic, 40 % decreased uptake and 16.7 % agenesis. All the ectopic thyroid were either lingual or sublingual, of which 60% were lingual. Technetium scan was found to be more sensitive and specific in identifying ectopic than ultrasound neck.
