Age of Clinical Diagnosis of Congenital Hypothyroid: Twenty Years Later

Trabajo presentado al XXI Congreso Peruano de Pediatría. Iquitos, 2010.

Abstract

Objective: Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation, for this reason it is important the early identification of infants with CH and prompt institution of treatment. The purpose of this work is determine the current age of diagnosis of the congenital hypothyroid by clinical criteria.

Methods: We performed a retrospective, descriptive, and longitudinal study. We review 247 Medical records and only 37 met the inclusion criteria and were analyzed. The data were entered on a form drawn up for this purpose, following the diagnosis by Blanco- Lopez et al. , anthropometry data were analyzed with EPI-INFO 2002 program. The analysis of the collected data was performed with statistical program Statistical Package for the Social Science (SPSS Inc. Chicago III) v15. 0.

Results: An increased incidence in females (78) than in males (22), was found with a ratio of 3.621. The average age at the time of diagnosis was 5.93 ± 5.28 month to the total sample. The clinical characteristics at the time of diagnosis were: bloated facies (73%), dry skin (70. 3%), large fontanelles (70.3%), constipation (64.9%), hypotonia (64.9%) and jaundice (64.9%). Likewise, evidenced a marked growth retardation. Subsequent to diagnosis and administration of l-thyroxine, the growth pattern shows tracking of growth in what should be its pattern of growth and improvement of the weigh.

Conclusions: The average age of diagnosis of congenital hypothyroidism was 5.93 ± 5.28 months, which contrasts sharply with the age at diagnosis found by a previous report (1992), with a higher frequency in females. The training of Pediatric fellows at the early clinical detection of this entity has allowed to decrease the age of diagnosis of this entity, being not yet optimal, so congenital hypothyroidism screening program be extended to national level.