2: Endocrine - Hypothyroidism Flashcards
What are the two types of paediatric hypothyroidism
- Congenital
- Acquired
Which gender is congenital hypothyroidism more prevalent
Female
What are 5 causes of congenital hypothyroidism
- Thyroid gland dysgenesis (85%)
- Pendred syndrome
- Iodine deficiency
- Congenital TSH absence (Rare)
- Maternal medications - propylthiouracil
What is Pendred syndrome
Thyroid gland w/ absence thyroid H
What drug can cause congenital hypothyroidism
Propylthiouracil
What are causes of acquired primary hypothyroidism
- Hashimotos thyroiditis (85%)
- Iodine deficiency
- Reidel thyroiditis
- De Quervain’s thyroiditis
What are causes of secondary hypothyroidism
- Cranial tumour
- Pituitary irradiation
What is riedel’s thyroiditis
Infiltration thyroid gland with fibrous tissue
What is Dequervain’s thyroiditis
Post-infection there is inflammation thyroid gland causes hyperthyroidism followed by hypothyroidism
What are 5 symptoms of congenital hypothyroidism
- Prolonged jaundice
- Puffy face
- Macroglossia
- Short-stature
- Hypotonia
- Developmental Delay
Explain puberty in acquired hypothyroidism
Delayed puberty. Can present with pseudo-puberty where there is isolated breast or testes development
What can congenital hypothyroidism lead to
Cognitive impairment
What is used to investigate congenital hypothyroidism
Neonatal heel prick test at 5-9d, looks for TSH
If neonatal heel prick is positive, what is next-line investigation
Thyroid US to identify dysgenesis = most common cause
How is acquired hypothyroidism diagnosed
TFTs, then autoantibody test
