Early Diagnosis Of Hypothyroidism Research Articles

Social and clinical factors associated with the early diagnosis of hypothyroidism in Down syndrome

Objective: To establish the social and clinical factors associated with the early diagnosis of hypothyroidism in patients with Down syndrome in a highly complex hospital in Colombia. Methodology: An observational, cross-sectional and analytic study was conducted in patients with hypothyroidism and Down syndrome aged three years old or younger, attended between the years 2017 - 2018. We had as secondary source the information of the clinical histories and as primary source a telephone survey carried out to the caregiver of the patient, we evaluated demographic, social and clinical variables. Results: 144 clinical histories were evaluated, of which 78 were able to comply with the variables; 32 patients presented hypothyroidism and with them the investigation was carried out. The early diagnosis of hypothyroidism, understood as that before 6 months of age, was 59. 4%. Clinical hypothyroidism was 71. 1% with connection to the subclinical, 87. 5% had thyroid stimulating hormone (TSH) levels lower than 15 mU/L neonatal and 3% of the population had congenital hypothyroidism. 50% of cases were diagnosed with hypothyroidism in the first three months of life. The height at birth in relation to the early diagnosis of hypothyroidism presented an RP: 14, IC 95%: 1.06-186. Conclusions: Early diagnosis of hypothyroidism has an association by the size of the patients at birth. Continuous monitoring of thyroid function in the first months and years of life of patients with Down syndrome, independent of neonatal TSH values, should be performed.

Prolonged Untreated Disease and Limited English Proficiency: A Case of Van Wyk-Grumbach Syndrome

Children from families with limited English proficiency have worse health outcomes than those from English-speaking families, likely related to the impact of a variety of social determinants on an increased risk of delayed presentation, diagnosis, and loss to follow-up. Van Wyk-Grumbach syndrome (VWGS) is a result of prolonged untreated primary hypothyroidism and early diagnosis of hypothyroidism is critical to prevent VWGS from developing. Whether social determinants of health, particularly limited English proficiency, impact the development, diagnosis, and treatment of VWGS has not been discussed previously. Here, we describe the case of an adolescent girl diagnosed with VWGS whose primary caregiver is foreign-born and with limited English proficiency, explore factors that may have placed her at increased risk for delayed presentation of VWGS, and discuss ongoing challenges of her disease management. We briefly review the pathophysiology of VWGS, emphasize the importance of being sensitive to this atypical presentation of hypothyroidism, and explore the intersections of this case with limited English proficiency status.

A study of correlation between thyroid disorders and menstrual disorders in reproductive age group

Present study to evaluate and detect thyroid dysfunction and its correlation in patients with a menstrual disorder in the reproductive age group. Research objectives are to study the prevalence of thyroid disorders in relation to menstrual disorders and study the correlation between menstrual irregularities and thyroid dysfunction. Precise assessments of thyroid hormones in serum become achievable easily and accurately with the introduction of new hormographical research techniques. Hypothyroidism diagnosis is advantageous because it typically relieves the patient of all symptoms. Therefore, the assessment of thyroid activity forms an essential component for the evaluation of a female with menorrhagia or otherwise menstrual irregularities. The individuals are rescued from repeated curettage from hysterectomy by early diagnosis of hypothyroidism Objectively measured menstrual blood losses were 35 ml per menstrual cycle (patients in the age group exposures.

Study of the Consequences of Mothers’ Hypothyroidism in Children: A Systematic Review

Introduction: Hypothyroidism is a common endocrine disorder that, occurs in 2% to 5% of pregnancies. During pregnancy, the body’s demand for thyroid hormones increases, which affects the growth of the fetus. In case of inadequate and defective production of thyroid hormones, adverse effects on the development of the fetus will appear. Lack of symptoms of hypothyroidism during pregnancy causes late diagnosis, resulting in a lack of timely treatment and impaired fetal development. The purpose of this review is to investigate the effects of mothers’ hypothyroidism on children. Methods: This systematic review study was performed by searching the Google Scholar, PubMed, and Science Direct databases for the period between 2018 and 2008 by including the keywords for hypothyroidism, thyroid hormones, growth in the uterus. A number of papers related to the use of the Cochran seven-step model were obtained and analyzed for the final analysis. Results: Thyroid hormones play a vital role in fetal development for ectopic life, through direct and indirect mechanisms that, act on the development of the fetus. Thyroid hormones help in the synthesis of surfactant and lung evolution, stimulation of secretion of catecholamine, increased beta-adrenergic receptors of the lung and stimulation: the activity of sodium and potassium pumps in the alveolar cell surface, the effect on the transmission of brain neurotransmitters and growth hormone, and nervous function. Conclusions: Thyroid hormones play a key role in fetal development. Therefore, in women with hypothyroidism, especially when not treated, it affects the development of the fetus and increases the incidence of complications in neonates. So early diagnosis of hypothyroidism and adequate and timely treatment during pregnancy is cornerstone in preventing impaired growth and development of the fetus and the occurrence of defects in childhood.

Congenital Hypothyroidism in Preterm Newborns: A Retrospective Study Arising from a Screening Program in Fars Province, Southwestern Iran.

ObjectivesThere is a high interest in the early diagnosis of hypothyroidism in preterm newborns for preventing any intellectual disability. Our study sought to determine the incidence of abnormal thyroid-stimulating hormone (TSH) between three and six days old and in weeks two, six, 10, and 12 after birth to evaluate the validity of repeating the test in premature infants.MethodsWe conducted a retrospective review of 320 886 live births in Fars province, Southwestern Iran, from March 2014 to October 2017. TSH levels in premature infants were measured by heel prick test, and the data was collected from the central newborn screening center of Fars province.ResultsThe number of premature newborns was 15 381, and the prevalence of hypothyroidism was 2.3%. Among 355 premature newborns with high TSH, 31.3% was detected in three to six days of life, 43.9% in the second week, 14.4% in the sixth week, 9.9% in the tenth week, and 0.6% in the twelfth week as hypothyroidism.ConclusionsOur results showed that thyroid screening of preterm infants needs retesting in two, six, and 10 weeks after to detect cases in newborns who would not otherwise be identified.

Comparison of sleep in hypothyroid patients with normal controls

Background: Sleep - A complex amalgam of behavioral and electrophysiological process is maintained by organized interaction between neurons, neural circuits, and neurotransmitters. Hypothyroidism is the inadequate secretion of thyroid hormones by the thyroid gland. Hypothyroidism, the 2nd common endocrine disorder, is often accompanied by complaints of daytime fatigue. This chronic fatigue should be managed as it may result in impaired attention with adverse consequences in the classroom, workplace, not to forget the highways. Aims and Objectives: The primary focus of the present study is to evaluate sleep cycle in newly diagnosed overt hypothyroid patients to investigate if this fatigue is the consequence of sleep disorder. Materials and Method: A total of 30 hypothyroid patients of both sexes underwent polysomnography to assess sleep based on bioelectric potentials - electroencephalogram, electromyogram, and electrooculogram. The results were compared with age- and sex-matched euthyroid controls. Results: Hypothyroid patients showed significant changes in sleep stages when compared with normal euthyroid controls. Although their total sleep time was not significantly altered, Stage I and Stage II sleep was significantly increased (P < 0.001) while deep sleep and rapid eye movement sleep were reduced. Conclusion: This research proves that early diagnosis of hypothyroidism and management guarantees an improvement in sleep quality and productivity in life.

292 HYPERBILIRUBINEMIA AND IDIOPATHIC HYPOPITUITARISM IN THE NEWBORN PERIOD

The association between neonatal hypopituitarism and liver dysfunction with prolonged jaundice has been made. We describe two patients who presented with severe neonatal hypoglycemia (HG), hepatomegaly, and hyperbilirubinemia (direct and indirect). There was clinical and laboratory evidence of hypothyroidism, hypo-adrenalism, hypogonadism and growth hormone (GH) deficiency in both. Case 1 (female) had 4 blood exchange transfusions. Liver enzymes were slightly elevated and bilirubin levels returned to normal within 5 months. A liver biopsy showed mild portal inflammation. Growth rate (GR) was 50% of normal during the first 6 mo. in the absence of demonstrable GH release. Somatomedin(SM) levels were 50% of normal childhood levels at 3 mo. but decreased to hypopituitary levels thereafter. SM increased 3.5 fold and GR was 80% of normal after GH treatment was added to T4 and cortisol replacement therapy. Case 2 (male) had grossly abnormal liver function tests, required 1 blood exchange transfusion and hyperbilirubinemia lasted for 8 mo. A liver biopsy revealed giant cell hepatitis. Despite T4 and cortisol therapy, hypoglycemic episodes continued until GH treatment was begun at 2½ yrs. Vigorous treatment of HG and early diagnosis of hypothyroidism and hypoadrenalism are crucial for a successful outcome. HG enhances the production of unconjugated bilirubin, but this can only partially explain the observed liver dysfunction in neonatal pan-hypopituitarism where T4 and GH deficiency likely also play a role.