CLINICAL CONFERENCE ON “CONGENITAL HYPOTHYROIDISM”

CLINICAL CONFERENCE ON “CONGENITAL HYPOTHYROIDISM”

October 24, 2023 at the department of propaedeutics of children's diseases of the State Educational Institution “Avicenna Tajik State Medical University" the clinical conference on the theme: "Congenital hypothyroidism" was held by the staff of the department together with doctors of the 7th children's somatic bulding of the State Institution "Medical Complex Istiqlol".

Congenital hypothyroidism is a complex of clinical and laboratory manifestations occurring in a child from birth with insufficiency of thyroid hormones or insensitivity of the tropic organs to them. Symptoms include lag in psychophysical development, myxedema, trophic disorders of the skin and its appendages, depressed heart function, decreased basal metabolism. Diagnosis is based on the characteristic clinic, X-ray diagnostic data, thyroid ultrasound, ECG, laboratory tests, including measurement of thyroid hormone and thyroxine in plasma. Treatment involves lifelong replacement therapy with artificial analogs of thyroid hormones. Congenital hypothyroidism is the most common endocrine pathology in pediatrics. Most often the disease occurs against the background of changes directly in the thyroid gland, less often it is the result of pathology of the hypothalamic-pituitary system or defective structure of the receptor apparatus of the tropic organs. In 90% of cases it is sporadic. The incidence is 1:3.7-4 thousand newborns in Europe and the USA, in Japan - 1:6-7 thousand. The female sex has the disease 2-2.5 times more often than the male. The first screening tests for congenital hypothyroidism were performed in 1973 by Canadians J. Dussault, S. Laber. Dussault, S. Laberge. At present, neonatal screening is carried out in order to make a diagnosis as quickly as possible and, if necessary, to provide timely treatment.

Forecast in congenital hypothyroidism depends on the adequacy and timeliness of treatment. With early diagnosis and timely initiated therapy, normalization of TTG and T4 levels - the prognosis for psychophysical development is favorable. In the absence of treatment during the first 3-6 months of life, the prognosis is doubtful even with the correct further therapeutic tactics. With adequate selection of the dose of drugs, the rate of psychophysical development reaches the physiologic norm, but the lag in intelligence remains. Prevention consists of antenatal protection of the fetus, medical and genetic counseling when planning pregnancy, rational diet and adequate iodine intake when carrying the child.

The presentation was prepared by Shamsulloeva Sh. Z., a resident physician of the department of pediatric endocrinology, who detailed the etiology, pathogenesis, risk factors, clinical features of the course, diagnosis, treatment, prevention and prognosis of congenital hypothyroidism with a demonstration of a patient. Special attention was paid to information about the most common complications in congenital hypothyroidism.

 

       In conclusion, a discussion was held, a number of questions were asked and answered comprehensively.

Department of propaedeutics of children's diseases

translated

Ruzimuhammad Ismoilov


24.10.2023 974
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