Thyroid disease in child Flashcards
What is congenital hypothyroidism in a child
Usually refers to congenital hypothyroidism - lack from birth -associated with neuro issues, poor growth and jaundice if untreated
causes - Thyroid defects (75%) -not inherited
disorder of thryroid hormone metabolism (inherited )-
Hypo/pit dysf -tumour, ischemia, congenital
Transient -maternal medication (carbimazole), maternal AB (hashimoto)
Sx -always be susp of Jaundice
Feeding difficulties, lethargy, constipation, JAUNDICE
Large fontanelles, myxeodema (swelling, nasal obstruction, low temp, hypotonia, pleural effusion, short stature, odedema
depending on cause - goitre, congenital dfects
Child unique - Coarse features, macroglossia, umbilical hernia
Ix and mx of congenital hypothyroidism in children
Ix - TSH high and T4 low
Thyroid antibodies- can be high depending on cause
US/radionucleotide scan
Mx-
early detect and replace
levothyroxine, titrate with TFT and monitor
monitor growth milestones, development
What is aquired hypothyroidism in children? (full)
Primary hypothyroidism -
most common cause =hashimotos thryroiditis (own AB, not mothers)
Very associated with - Downs, turners
Sx - Growth failure, weight gain, short stature, cold, constipation etc (normal adult signs)
mx - levothyroxine -if caught early catch up growth occurs
What is congenital/neonate hyperthyrodisim in chidren (full)
if mother has graves disease -1-2% of new borns with have circulating TSHR AB (cross placenta) and stimulate T4 prod -hyperthyroidism
Sx -
in foetus -high CTG trace and Foetal goitre on USS
Neonate (<2w) - irritable, Weight loss, ttachycardia, heart failure, diarrhoea, exophtalmos)
Ix -TSH low, T4 high
Mx - Medical <2y Carbimazole or propylthiouracil CARE --Both are associated with neutropenia -SAFETY NET IF SORE THROAT/FEVER Bblocker for sx relief
other - radioiodine and repalce
surgery and replace
like adults