Hypothyroidism (2)

Question 1

What are THs essential for?
→ Therefore, in who is thyroid function important to check?

Answer 1

Brain and body development
→ Any child with neurodevelopmental and growth problems

Question 2

Congenital:
N.B. Most common endocrinopathy affecting newborns

What is it commonly due to?

When is it screened for?

Answer 2

➊ Underdeveloped thyroid (dysgenesis), or a fully developed thyroid that doesn’t produce enough hormone (dyshormonogenesis)

➋ During newborn blood spot screening test

Question 3

Acquired:
What is the most common cause of it?
→ What occurs here?

What are other causes?

Answer 3

➊ Hashimoto’s/Acquired Thyroiditis
→ Autoimmune inflammation and subsequent gland underactivity
• Associated with Anti-TPO

➋ Antithyroid meds e.g. Lithium, Amiodarone, Hyperthyroid meds etc.

Question 4

How does it present?

Which investigations should be done?

How is it managed?

Answer 4

➊ • Slow growth and development
• Poor feeding and growth
• Fatigue, Increased sleeping, Reduced activity
• Constipation, Infrequent changing of nappies
• Dry, thin hair and skin

➋ • TFTs – Low T3 and T4, High TSH (if primary, which is the most common)
• Anti-TPO – to identify cause e.g. Hashimoto’s

➌ Levothyroxine