Endo - Hypothyroidism

Question 1

What does undiagnosed hypothyroidism lead to?

Answer 1

Significant problems with neurodevelopment and intellectual disability

Question 2

What is congenital hypothyroidism?

Answer 2

Child born with underactive thyroid gland

1/3000 new-borns

Question 3

What causes congenital hypothyroidism?

Answer 3

Underdeveloped thyroid (dysgenesis)
Fully developed that does not produce enough thyroid hormone (dyshormonogenesis)

Very rarely due to pituitary or hypothalamus

Question 4

How is congenital hypothyroidism picked up?

Answer 4

Screened on new-born blood spot screening test

Question 5

How can congenital hypothyroidism present?

Answer 5

Prolonged neonatal jaundice
Poor feeding
Constipation
Increased sleeping
Reduced activity
Slow growth and development

Question 6

What is acquired hypothyroidism?

Answer 6

Child or adolescent develops underactive thyroid when it was previously working

Question 7

What is the most common cause of acquired hypothyroidism?

Answer 7

Autoimmune thyroiditis (Hashimoto’s thyroiditis)

Anti-TPO
Anti-thyroglobulin antibodies

Question 8

What is Hashimoto’s associated with?

Answer 8

Type 1 diabetes
Coeliac disease

Question 9

What are the symptoms of acquired hypothyroidism?

Answer 9

Fatigue and low energy
Poor growth
Weight gain
Poor school performance
Constipation
Dry skin and hair loss

Question 10

How is hypothyroidism managed?

Answer 10

Managed by paediatric endocrinologist

TFTs
Thyroid USS
Thyroid antibodies

Levothyroxine daily, titrated based on tests and symptoms