2018, Number 4
Acta Pediatr Mex 2018; 39 (4)
Díaz PEJ, Sánchez PMC, Moreno MH, Echeverría AJC, Rivera GIR, Calzada LR, Ruiz-Reyes ML, Ontiveros ME, Altamirano BN Mandujano VMA
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ABSTRACTIntroduction: The primary congenital hypothyroidism (PCH) persists with alterations in processes cognitive.
Objective: to evaluate the cognitive functions of children with PCH as a response to a comprehensive transfunctional treatment.
Material and Methods: An observational, analytical, prospective and longitudinal study of a 2003-2004 cohort of children with PCH, treated in the Service of Endocrinology and incorporated in a neurodevelopmental follow-up program at the Laboratory of the National Institute of Pediatrics. The cases were assessed using the Wechsler Intelligence Scale for pre-school and primary (WPPSI) at 4, 5 and 6 years. We obtained the total intelligence quotient (IQ), and verbal and executive quotients by direct scores. Standardized and scalar ages of the cognitive processes of attention, memory and conceptualization were also assessed.
Results: 32 (71.8% female) patients with PHC, [53% for thyroid agenesis and 47% with thyroid ectopy, on treatment with levothyroxine According to the IQ at the age of four, 12% patients had limited scores that persisted up to 6 years and 12% showed mental deficiency that improved at 6 years. In two-thirds of them the IQ was normal, finding that the IQ of one-third of these patients was normal brilliant or higher, depending on the classification of WPPSI. The auditory memory and conceptualization functions were the most affected regarding the cognitive trajectory. Scalar estimated ages were found lower than the chronological age. Was possible to predict cognitive path up to the 6 years at 4 years. The overall risk factors of the PHC outcomes were thyroid agenesis, delayed onset of treatment and higher hormonal doses. Maternal participation, higher stimulation at home and better socioeconomically condition was considered as protective factors.
Conclusions: The variability of the cognitive evolution in cases with PHC allowed characterizing both the risk and protective factors to define early cognitive intervention in children with PHC.