Growth Assessment of Pre-School Children (1 to 4 Years of Age) Suffering from Congenital Hypothyroidism

Author(s): Ashok Kumar1 , Shweta Joshi2 , Sushil Ojha3

BACKGROUND Most common preventable reason for growth retardation and mental retardation is hormone deficiency of thyroid known as congenital hypothyroidism. In most of the cases of Congenital Hypothyroidism the cause is thyroid dysgenesis (abnormal development of thyroid) in around 80 to 85% of cases, and in 15 to 20% cases the cause is dyshormogenesis. As there is absence of signs and symptoms of Congenital Hypothyroidism in a newborn it may lead to delayed diagnosis in a newborn and leading to mental retardation and failure in normal growth attainment. So, neonatal screening is essential in every childbirth. We wanted to assess the growth of preschool child (1 to 4 years of age) suffering from congenital hypothyroidism. METHODS We have included children (age range from 1 to 4 years) on treatment with thyroxine hormone for the congenital hypothyroidism enrolled in Department of Pediatrics of Government Medical College (GMC), Haldwani, Nainital, Uttarakhand in December 2015 to November 2016. Exact age of the child was determined from the birth certificate. Each child was measured for growth. Patients were divided into 2 groups - Group 1 severe CH (pretreatment T4 level or = 4 microg/dL) (n = 6 total, 4 male, 2 female). RESULTS All patients who received treatment at an early age showed normal measurable growth parameters; but girls were taller than boys in first year. Boys showed some comparative delay of measurable growth parameters compared to female children. In our study, the final growth attained at the age of 4 years did not show any statistically significant difference between mild and severe CH groups and had normal measurable growth parameters. CONCLUSIONS Early diagnosis and early treatment for CH can prevent the measurable growth parameter disorder in children. Normal measurable growth parameters in both mild and severe CH group are similar, if they are given thyroid hormone supplementation therapy. Age of normalisation of thyroid hormone after treatment is very important predictor of normal growth parameter attainment with growing age. Female children respond faster than male children.