- Congenital hypothyroidism in children: the intellectual development and psychosocial adaptation
Congenital hypothyroidism in children: the intellectual development and psychosocial adaptation
SOVREMENNAYA PEDIATRIYA.2017.4(84):107-111; doi 10.15574/SP.2017.84.107
Sorokman T. V., Popeliuk N. O.
Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi
Objective — to estimate the degree of intellectual development and psychosocial adaptation of children with congenital hypothyroidism (CH).
Materials and methods. There were examined 22 patients with CH aged from 1 month to 15 years. The evaluation of the results of such methods as ultrasonography, EEG, hormone panel, logopaedic and audiologic examination, assessment of intelligence (Wechsler Intelligence Scale for Children) and individual peculiarities of personality (Children's drawing test) was performed. Statistical analysis was conducted using the software Statistica 6.0.
Results. In 38.1% of patients, the nodular formations of thyroid gland were diagnosed. The positive correlation between the age and the presence of nodular formations (r=0,76; p<0,001) was observed. The TSH median on the first stage screening was 38 mkU/L. The vT4 level ranged from 0.49 to 14.7 pmol/l. Audiological examination revealed the diminished hearing in 43.8%, the logopaedic one showed the general delay or retardation in early language in 36.3% of cases. The average IQ of children with CH was on the lower limit of normal and made up 88.9±1.52 points. General IQ depended on the capacity of the shortterm memory (r=0.6; p<0.05). Besides, it was significantly lower in children with the declined processes of memorization (103.2±9.6 points). In 45.4% of cases, the functional changes of diencephalic areas of the cerebral cortex were observed. The most common psychological parameters in children with CH appeared depression (p<0,05), aggression and anxiety were almost equifrequent.
Conclusion. The children with CH have different health deviations, such as nodal formations in thyroid gland, diminished hearing, delay or retardation in early language development and functional changes in the electrical activity of cerebral cortex. The general IQ in most children with CH is within the normal range in the case of timely treatment.
Key words: children, congenital hypothyroidism, intellectual development, psychosocial adaptation.
1. De Benua B, Shvets OV. (2011). Elimination of iodine deficiency is one of the key health problems. Mezhdunarodniy endokrynolohycheskyy zhurnal. 6 (38): 9-17.
2. Dyleo D. (2002). Children's drawing: diagnostics and interpretation. M: 120.
3. Klymenko TA, Bezlepkyna OB, Chykulaeva OA. (2010). Intellectual development in congenital hypothyroidism. Klynycheskaya y эksperymental'naya tyreoydolohyya. 6(4): 17-21.
4. Fylymonenko YuY, Tymofeev VY. (2006). Wexler's test. Diagnosis of the level of development of intelligence: Methodological guide (WISC): 120.
5. Kollati Y, Ambati RR, Reddy PN et al. (2017). Congenital Hypothyroidism: Facts, Facets & Therapy. Curr Pharm Des. Feb 6. https://doi.org/10.2174/1381612823666170206124255; PMid:28176629.
6. Gejão MG, Lamônica DA. (2008). Development skills in children with congenital hypothyroidism: focus on communication. Pro Fono. 20(1):25-30. https://doi.org/10.1590/S0104-56872008000100005; PMid:18408860.
7. Heidari Z, Feizi A, Hashemipour M et al. (2016). Growth development in children with congenital hypothyroidism: the effect of screening and treatment variables-a comprehensive longitudinal study. Endocrine. 54(2):448-459. https://doi.org/10.1007/s12020-016-1010-x; PMid:27477291
8. Ferianec V, Papcun P, Grochal F et al. (2016). Thyroid Imaging in Infants. Endocrinol Metab Clin North Am. 45(2):255-66. https://doi.org/10.1016/j.ecl.2016.02.005.
9. Bastug O, Korkmaz L, Halis H et al. (2017). Thyroid status of iodine deficient newborn infants living in central region of Turkey: a pilot study. World J Pediatr. Feb 14. https://doi.org/10.1007/s12519-017-0017-6; PMid:28194694.