Sánchez PC, Calzada R, Ruiz L, Altamirano N, Méndez I, Vela AM, Gamboa CS, Mandujano M

Language: Spanish
References: 23
Page: 272-279
PDF size: 118.42 Kb.

ABSTRACT

Objective. To know the clinical expression of the congenital hypothyroidism (CH) in neonates and babies with an screening test positive to this disease.
Material and methods. Fifty four infants below 15 weeks age with an screening test positive and the diagnosis of CH confirmed were studied. The clinical signs were related according as the hypothyroidism were by athyrosis (AH) or ectopia (EH), the biochemical severity of the hormonal deficit and the age of the child at the diagnosis. The differences between this data in AH and EH were studied in connection with the gammagraphy and the bone maturation (retarded or normal). The clinical signs were organized in conglomerates, in order to see the association among these variables.
Results. The symptomatic groups were correlated to delay bony age, open posterior fontanel, umbilical hernia, lethargy and hypotone, hoarse cry and macroglosia, as greater signs, and prolonged jaundice, cold an dry skin and hypothermia as minor signs, they were observed with more frequency in cases with AH and in at least half of the cases with EH.
Conclusions. The conglomerated of HC and delate of bony age, with the presence of greater signs, seems to be the highest risk for neurological lesion.

REFERENCES

1. Loera-Luna A, Aguirre B, Gamboa S, Vargas H, Robles C, Velásquez A. Resultados del programa para la prevención del retraso mental producido por hipotiroidismo congénito. Bol Med Hosp Infant Mex 1996; 53: 259-263.

2. Vela M, Gamboa S, Loera-Luna A, Aguirre BE, Pérez-Palacios G, Velázquez A. Neonatal screening for congenital hypothyroidism in Mexico: experience, obstacles, and strategies. J Med Screen 1999; 6: 77-9.

3. Norma Técnica 321 para la prevención del retraso mental producido por HC. En: Diario Oficial de la Federación. México 1988; 420: 88-90.

4. Norma Oficial Mexicana: Atención de la mujer en el embarazo, parto y puerperio y del recién nacido. En: Diario Oficial de la Federación 007-SSA-2. 1993: 127-153.

5. Letarte J, Guyda H, Dussault JH, Glorieux J. Lack of protective effect of breast-feeding in congenital hypothyroidism: report of 12 cases. Pediatrics 1980; 65: 703-5.

6. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd. ed. Stanford, Calif.: Stanford University Press 1959.

7. Pyle SI. A radiographic standard of reference for the growing knee. Springfield, IL.: Charles C. Thomas 1969.

8. Pyle SI, Waterhouse AM, Greulich WW. Attributes of the radiographic standard of reference for the National Health Examination Survey. Am J Phys Anthropol 1971; 35: 331-7.

9. Hulse AJ, Grant DB, Jackson D, Clayton BE. Screening for congenital hypothyroidism. Lancet 1979; 2(8149): 968-9.

10. Virtanen M. Manifestations of congenital hypothyroidism during the 1st week of life. Eur J Pediatr 1988; 147(3): 270-4.

11. Grant DB. Congenital hypothyroidism optimal management in the light of 15 years’ experience of screening. Arch Dis Child 1995; 72(1): 85-9.

12. Bamforth JS, Hughes I, Lazarus J, John R. Congenital anomalies associated with hypothyroidism. Arch Dis Child 1986; 61(6): 608-9.

13. Bamforth JS, Hughes IA, Lazarus JH, Weaver CM, Harper PS. Congenital hypothyroidism, spiky hair, and cleft palate. J Med Genet 1989; 26(1): 49-51.

14. Fernhoff PM. Congenital hypothyroidism and associated birth defects: implications for investigators and clinicians. J Pediatr 1998; 132(4): 573-4.

15. Goujard J, Safar A, Rolland A, Job JC. Epidemiology of hypothyroidism due to congenital malformation of the gland: athyrosis or ectopic thyroid (author’s transl). Arch Fr Pediatr 1981; 38 (Suppl 1): 875-9.

16. Andersen HJ. Studies of hypothyroidism in children. Acta Paediatr 1961; 50(Suppl 125): 1-150.

17. Lowrey G, Aster R, Carr E, Ramon G, Beierwaltes W, Spafford N. Early diagnostic criteria of congenital hypothyroidism. A comprehensive study of forty-nine cretins. Am J Dis Child 1958; 96: 131-138.

18. Mäenpää J. Congenital hypothyroidism. Aetiological and clinical aspects. Arch Dis Child 1972; 47(256): 914-23.

19. Calzada LR, García C. Hipotiroidismo congénito. Acta Pediatr Mex 1996; 17: 360-363.

20. Gruters A, Delange F, Giovannelli G, Klett M, Rochiccioli P, Torresani T et al. Guidelines for neonatal screening programmes for congenital hypothyroidism. Working group on congenital hypothyroidism of the European Society for Paediatric Endocrinology. Eur J Pediatr 1993; 152(12): 974-5.

21. Gruters A, Delange F, Giovannelli G, Klett M, Rochiccioli P, Torresani T et al. Guidelines for neonatal screening programs for congenital hypothyroidism. European Society for Pediatric Endocrinology Working Group on Congenital Hypothyroidism. Horm Res 1994; 41(1): 1-2.

22. Raiti S, Newns G. Cretinism: early diagnosis and its relation to mental prognosis. Arch Dis Child 1971; 46: 692-694.

23. Hulse J, Jackson D, Grant D, Byfield P, Hoffenberg R. Different measurements of thyroid function in hypothyroid infants diagnosed by screening. Acta Pediatr Scand 1979; Suppl 277: 21-25.