Overview

• Undiagnosed Hypothyroidism → can cause problems with neurodevelopment and intellectual disability. May be congenital or acquired.
• Congenital Hypothydoisim → child is born with an underactive thyroid gland. Can be the result of an underdeveloped thyroid gland (dysgenesis) or a fully developed gland that does not produce enough hormone (dyshormonogenesis).
• Acquired Hypothyroidism → child develops an underactive thyroid gland when previously it was functioning normally.
  • Most common cause → autoimmune thyroiditis (hashimoto’s).

Making Diagnosis

Clinical Features

• Congenital Hypothyroidism → prolonged neonatal jaundice, poor feeding, constipation, increased sleeping, reduced activity, slow growth and development. Hypotonia. MACROGLOSSIA and UMBILICAL HERNIA.
• Acquired Hypothyroidism → fatigue, low energy, weight gain, poor school performance, constipation, dry skin, hair loss.

Investigations

• TFTs + Thyroid Ultrasound + Thyroid Antibodies.
• Congenital Hypothyroidism → screened for on the newborn blood spot screening test.

Management Plan

• Hypothyroidism → oral Levothyroxine once daily.

Complications → increased risk of other auto-immune conditions (T1DM, RA, vitiligo).

Prognosis →