HYPOTHYROID CONNECTIVE: Filter as early as possible to prevent the baby from experiencing mental retardation

Every parent will add children in good health and quality. All parents want their babies to be normal, but unexpected events sometimes occur, such as growth and developmental disorders that reduce the quality of life of children. Congenital hypothyroidism (HK) is one of the causes of this condition.
Congenital hypothyroidism is 1: 3000-4000 live births worldwide and the incidence of congenital hypothyroidism in Indonesia is 1: 3528 live births. With a population of 200 million Indonesians and a birth rate of 2%, 4 million babies are born every year and every year in Indonesia, around 1,143 babies are born with congenital hypothyroidism.
Congenital hypothyroidism is a condition in which the work of the thyroid gland in children decreases or even no longer functions at birth. Therefore babies do not have thyroid hormones. Thyroid disorders in infants can affect their growth and development, both physically and mentally.

Thyroid hormone, thyroxine, which consists of tri-iodotironine (T3) and tetra-iodotironine (T4), is a hormone produced by the thyroid gland (thyroid). Its formation requires iodized micro nutrients. The function of this hormone is to regulate body heat production, metabolism, bone growth, heart work, nerves, and brain growth and development. Thus, this hormone plays a very important role in infants and growing children. The absence of thyroid hormones in infants and early life can cause delayed growth and mental delay.

Symptoms and signs of congenital hypothyroidism


More than 95% of babies with HK have no symptoms at birth. Even if there is a very vague and not typical. Without treatment, the symptoms appear more and more with age.

Symptoms and signs that may occur are: lethargy (decreased activity), jaundice (yellow), macrogloss (large tongue), umbilical hernia (bulging), flat nose, constipation, dry skin, mottled skin (cutis marmorata)) / intermittent, easily blocked, hoarseness, hypotonia (decreased muscle tone), enlargement of the crown, distended abdomen, easy to chill (intolerance to cold) and myxedema (swollen face).

Impact of congenital hypothyroidism

Hypothyroidism in infants can be permanent (permanent) or temporary (temporary). Transient HK is known if, after a few months or years since birth, the thyroid is able to produce its own thyroid hormone, so treatment can be interrupted. Permanent HK requires lifelong care and special care.

The impact of HK on a very sad child is mental retardation that cannot be recovered. The impact on families, the economic burden, because children in Hong Kong need special education, care and supervision. At the psychosocial level, families will be more vulnerable to the social environment because of low self-esteem and will be stigmatized in the family and community, and their productivity will decrease as they care for children with HK. If we estimate that the incidence of HK is estimated at 1 newborn in 2000, out of 5 million births in Indonesia, more than 1,600 people with HK will be born every year and will have a cumulative impact on the quality of the next generation. the country's human resources. So that babies with HK do not have growth and development disorders, the only way to detect HK abnormalities as early as possible and treat them immediately (less than one month) is through screening tests.

HK screening


In Indonesia, congenital hypothyroidism (HK) is a fairly common disease among diseases that can be detected by newborn screening. The key to successful care of children with HK is early detection through laboratory tests and care before the child is 1 month old. HK itself very rarely shows clinical symptoms early in life. In the case of late discovery and early treatment, children will experience mental retardation with IQ abilities below 70.

treatment

L-T4 treatment is given immediately after the confirmation test results. Infants with severe HK receive high doses, whereas infants with HK mild or moderate receive lower doses. Babies with heart disorders start giving 50% of the dose and then increase it after 2 weeks.

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