Archive for the ‘Hypoglycemia In Children’ Category

Hypothyroidism

Hypothyroidism in infants:

and children, while relatively rare — approximately 1 in 4,000 infants have the condition– poses a serious threat to a child’s physical and mental development if left untreated. Hypothyroidism can affect both newborns and older children, and occurs for a variety of reasons, but the treatment is always the same.This article will explore the different types of hypothyroidism, methods for detection and treatment, and why it is crucial that your newborn be tested within the first few days of birth.Research has shown that women with thyroid disease are at more risk than previously thought of having infants who have birth defects, including abnormalities of the heart, kidney or brain, and other defects such as cleft lip and cleft palate.Looking further at the issue, a study published in 2002 reported on Argentine researchers, who looked at 150 pregnancies among women ages 16 to 39 years who had a diagnosis of hypothyroidism while pregnant. Thirty-four percent of the women — 51 pregnancies — were hypothyroid when they conceived. Among them, 16 were overtly hypothyroid — TSH more than 33.4 — and 35 were subclinically hypothyroid — TSH more than 12.9. A total of 99 pregnancies were conceived when the women were euthyroid — normal TSH range — and receiving thyroid treatment.

Different Types Of  Baby Hypothyroidism:

Congenital Hypothyroidism, or CH, refers to hypothyroidism which is present from birth. It is by far the most common form of hypothyroidism in infants, accounting for approximately 90 percent of hypothyroidism cases in infants. CH occurs when any part of the fetus’s thyroid system fails to develop correctly. Sometimes the gland does not descend fully into the proper place. In other instances the gland is in the proper location, but is underdeveloped. In rare cases, the thyroid may fail to produce or release the thyroid hormone properly. In these cases, the newborn has something called Thyroid Dyshormonogenesis. The genes for this disorder are inherited from both the mother and the father. The chance for the parents of a CH child to have another child with CH is 1 in 4 for every child born to them.CH, Transient Form, In about 10 percent of infants with CH, the hypothyroidism is transient, or temporary. This is usually because the mother has been treated for Graves’ Disease/hyperthyroidism during pregnancy, has a history of thyroid disease, or has been exposed to iodine-containing substances. Transient CH can last anywhere from several days to several months, but eventually will subside, and no further treatment will be necessary. If your child’s thyroid gland is properly located and not in any way malformed, she may very well have transient hypothyroidism.
Acquired Hypothyroidism, Acquired hypothyroidism, which affects older children and adolescents, typically develops in children due to autoimmune thyroid disease such as Hashimoto’s disease. It’s more common as children reach puberty or teenage years, but can still appear in young children. It is also more common in girls than in boys.

Major Causes Of  Baby Hypothyroidism:

In most industrialized countries, newborn infants are given a heel stick test (blood is drawn from the heel of the foot) within a few hours of birth. This test is often referred to as the PKU test, because it also covers phenylketonuria (PKU) as well as galactosemia, along with the screening for congenital hypothyroidism. It is worthwhile to double check with the hospital staff to make sure that the test covers CH along with PKU. This early blood test is by far the most reliable way to diagnose CH in infants.
Most newborns with CH show no clear symptoms of the disorder, and could potentially go for months with the disease undetected. It is essential that you have your newborn tested for CH within 3 days of birth. If the initial screening shows a low level of T4 hormone and/or the TSH hormone is elevated, further tests will likely be ordered to confirm a diagnosis of hypothyroidism. Usually, the blood test will be repeated to make sure that the initial test was accurate. Additionally, an x-ray of the baby’s legs will be taken to examine the ends of the bones in the knee area. In infants with hypothyroidism, the bones will appear underdeveloped. Often a scan is taken of the thyroid gland to determine if the gland is malformed or improperly located or even absent. These tests can all be done while the infante bones in the knee area.

• Hypothyroidism in the newborn may be caused by:
• A missing or abnormally developed thyroid gland
• Pituitary gland’s failure to stimulate the thyroid

Defective or abnormal formation of thyroid hormones
Incomplete development of the thyroid is the most common defect and occurs in about 1 out of every 3,000 births. Girls are affected twice as often than boys.

Treatment For  Baby Hypothyroidism:
No matter what form of hypothyroidism a child develops, the treatment is always the same. It involves prescription thyroid replacement hormone treatment, in pill form, taken daily. The average starting dose for an infant is between 25 and 50 mcg per day. The goal is for the newborn to have normal hormone levels within the first 4 weeks of life. This will require frequent, usually weekly, visits to the treating physician for follow-up blood tests and adjustment of the dosage. Once the baby’s hormone levels are properly adjusted, she or he will probably be seen every 2 to 3 months for the first 3 years of life. The treatment is daily replacement of the missing thyroid hormone with synthetic thyroid hormone tablets (also called sodium levothyroxine or L-thyroxine). The synthetic thyroid hormone acts exactly like the hormone produced by the thyroid gland. When given at the proper dosage, there are no side effects from taking synthetic thyroid hormone.This depends on how the lack of thyroid hormone has affected your baby before treatment. If the baby showed very few signs of hypothyroidism before treatment, they may change very little after treatment is started. The earliest changes, which occur 4 to 5 days after treatment is started, include.If your baby’s development has been slow, they should begin to gain new skills more quickly after thyroid hormone replacement is started.