Çocuk ve Ergenlerde Hipotirodi
Synopsis
In this study, hypothyroidism in children and adolescents is examined in detail within the framework of etiology, clinical findings, laboratory diagnosis, and treatment approaches. Thyroid hormone is critical for organ function, physical growth, and neurological development, and its deficiency leads to growth failure, short stature, fatigue, cold intolerance, constipation, dry skin, weight gain, bradycardia, goiter, and menstrual or pubertal disorders. Hypothyroidism can be congenital or acquired, and is classified as primary or secondary/central depending on whether the defect originates in the thyroid gland or the pituitary/hypothalamus. The most common cause of acquired hypothyroidism in children is Chronic Autoimmune Thyroiditis (Hashimoto's thyroiditis), which occurs four times more frequently in girls than boys and is confirmed by the presence of anti-TPO and anti-thyroglobulin antibodies. Congenital hypothyroidism occurs in 1 in 2,000 to 4,000 newborns, mostly results from thyroid dysgenesis, and is a major cause of preventable intellectual disability. Diagnosis should be established through heel prick screening between days 2 and 5 of life, and treatment must begin within the first two weeks at the latest to prevent impairment in neurocognitive functions. Laboratory evaluation involves measuring serum TSH and free T4 levels, while treatment utilizes individualized Levothyroxine tablets administered at least 30 minutes before breakfast and dosed according to age and body weight. Early diagnosis and regular monitoring every 3 to 6 months directly improve the clinical prognosis of patients.
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