TUMBUH KEMBANG ANAK HIPOTIROID KONGENITAL YANG SUDAH DITERAPI DENGAN LEVO-TIROKSIN SEJAK DINI

• Main Authors: , dr. I Ketut Adi Wirawan, , Prof dr. Sunartini Hapsara, Ph.D, Sp.AK
• Format: Theses and Dissertations NonPeerReviewed
• Published: [Yogyakarta] : Universitas Gadjah Mada 2012
• Subjects: ETD
• Online Access: https://repository.ugm.ac.id/98677/; http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=55623
• Institution: Universitas Gadjah Mada

Congenital hypothyroid (CH) is one of the preventable etiology of intellectual disability. This prevention managed by early detection and prompt hormone replacement therapy using levothyroxine (L-T4). Unfortunately, early detection for intellectual disability using CH screening is not a government routine program. This will lead to unprompted treatment of CH cases.The aim of this study was collecting growth and development features of children with CH that treated with L-T4. Design of this study was a case study. Toddler with CH that treated with L-T4 in Endocrinology Subdivision of Pediatric Clinic of Sanglah Hospital, Wangaya Hospital and Karangasem Hospital that recorded as outpatients since 2006, were deeply analyzed through their therapy and progression of the disease. Assessments of development were using mental and motor scale from Bayley II, while assessments of growth were using anthropometric measurement according to WHO 2005, and bone maturity was assessed with bone age. Each case was compared, by their similarities and differences and their impact on growth and development of the children. There were 8 cases were analyzed, it consists of 4 men and 8 women, age of diagnosis is between 3 to 18 months. Five subjects with severe CH 4 subjects with moderate CH, and 3 CH with clinically Down syndrome. When the diagnosis is upheld, the mean initial TSH is 130.73 uIU/ml (SD 194.89) and initial FT4 average 0.53 ng/dl (SD 0.53), and the mean of birth weight 2862,50 grams (SD 487,16). Who get early therapy there are 5 cases and 7 cases with nor early therapy. Psychomotor developmental index were better on children that given high starting dose compared to children that given standard dose. Outcome of growth showed better results after treatment with LT-4, and acceleration of growth can be achieved with early treatment.