Retrospective evaluation of growth parameters and treatment features of children diagnosed with congenital hypothyroidism between 2000-2012

Introduction: Congenital hypothyroidism is the most common endocrinological problem encountered in the neonatal period, occurring in approximately one in 2000-4000 live births. Thyroid hormones are the primary determinant of normal postnatal somatic growth and skeletal development and an important regulator of bone and mineral metabolism in humans. Untreated childhood hypothyroidism results in profound growth retardation and a delayed skeletal maturation.. Materials and Methods: In this study, patients who applied to Celal Bayar University Hafsa Sultan Hospital Pediatric Endocrinology Outpatient Clinic between January 2000 and December 2012 and were followed up with the diagnosis of congenital hypothyroidism were retrospectively analyzed. The calendar age (days), gender, anthropometric measurements and oxological data of the cases at the time of diagnosis, the age of onset of treatment (days), the starting dose of the drug in the treatment (mcgr/kg/d), the continuation of the treatment, the laboratory and radiological findings before the treatment and during the follow-up, the patient's mother It was examined in terms of whether there was thyroid disease and the data were recorded. The data were descriptive statistics (number, percentage distribution, mean, standard deviation, median, min-max values), t-test in dependent groups (Wilcoxon test when normal distribution conditions were not met), t-test in independent groups, (mann-whitney u in independent groups that did not show normal distribution). test), pearson correlation test and chi-square test. Statistical evaluation of the data was done in SPSS (Statistical Package for Social Science) 24 program. p≤0.05 was considered statistically significant. Results: In our study, 51.5% of the patients were diagnosed with permanent ch, 48.5% were diagnosed with temporary ch, the rate of permanent ch in female cases was 56.8%, and the rate of permanent ch in male cases was 47.3%. Permanent congenital hypothyroidism rates were found to be higher in the female patient group. In our study, a significant difference was found between the cases with a diagnosis of permanent and transient kh, in terms of the days of treatment when they were observed below tsh<10 u/ml and tsh<5 u/ml. In permanent congenital hypothyroidism cases, it was found statistically significant that the time for the Tsh level to fall below 10 u/ml and 5 u/ml was longer than the temporary kh group. In our study, in accordance with the literature, thyroglobulin levels were found to be: 217.18±110.84 ng/ml in the permanent ch group and 269.355±79.240 ng/ml in the temporary ch group. The tg levels were found to be higher in the temporary ch group, and this difference was statistically significant. as meaningful. In our study, when the treatment doses of patients diagnosed with permanent and transient ch were examined, the mean treatment dose in the permanent ch group was 1.74±1.12 mcg/kg/day, and the mean treatment dose in the temporary ch group: 1.33±1.07 mcg/kg/day. The mean treatment dose was found to be higher in the permanent kh group, and this difference was found to be statistically significant. When the bmi values of our cases are examined; 74 mean bmi: 18,27 ± 4.22 kg/m2. The mean bmi was found to be 16.88 ±2.81 kg/m2 in the transient ch group, and 19.59, ±4.87 kg/m2 in the permanent ch group. Conclusion: As a result, there are no routine tests that can give us clues before the diagnosis in the differential diagnosis of patients with temporary and permanent ch. As can be expected during the follow-up, the decrease in TSH levels is faster. During treatment, there is no difference between patients with permanent and transient hypothyroidism, especially in terms of anthropometric parameters. This shows the importance of diagnosis time and efficacy of treatment, especially in patients with permanent hypothyroidism.