Thyroid diseases are very common in the world. They can affect both adults and children. In the human body, the thyroid gland plays a very important role, as it is responsible for all metabolic processes. Violations in her work are fraught with the development of serious pathologies. According to statistics, in children hypothyroidism is most often observed. What is it? We learn in the article.
What is hypothyroidism?
Hypothyroidism in children is an endocrine disease in which there is insufficient thyroid hormone production of the thyroid group. Their lack provokes deviations in the mental and physical planes, especially in children under three years of age. At an older age, the disease does not provoke persistent changes in the body, but can lead to other, no less serious consequences. Pathology is more often manifested in girls. Recently, hypothyroidism has been diagnosed much more often. Some experts see the reason for this in poor ecology and insufficient consumption of iodine-containing products.
This disease quickly turns into a chronic form. It is very important to diagnose it as soon as possible in order to start the necessary therapy in a timely manner.
Types of disease
Hypothyroidism is usually divided into two types:
- Primary. In this case, the cause of the disorder is damage to the thyroid tissue.
- Secondary. When there is a lesion of the pituitary gland - an important link in the endocrine system.
Primary hypothyroidism in a child is usually divided into:
- Congenital - disorders occur in the prenatal period. Sometimes a hereditary factor plays a role.
- Acquired - develops at a later age under the influence of autoimmune and inflammatory processes in the body, as well as with a lack of iodine.
Also, this disease is usually divided according to severity. The following forms are distinguished:
- Subclinical hypothyroidism in children (hidden). When a blood test is observed, an increase in the hormone TSH against the background of normal levels of other thyroid hormones. The disease of this form is asymptomatic, therefore this type of hypothyroidism is very dangerous. In the absence of timely treatment in children, irreversible consequences may begin, although in the early stages, the pathology is quite successfully treated. But as a rule, due to the latent form of the course, the disease is diagnosed already in the later stages.
- Clinical hypothyroidism in children is characterized by severe symptoms.
- A severe degree of the disease is observed with a prolonged course of the disease. May provoke hypothyroid coma, cretinism and other serious pathologies.
Causes of pathology
There are many reasons why a disease develops. Congenital and acquired forms of the disease occur on various occasions.
The following factors influence the development of the congenital form:
- genetic inheritance;
- diseases of the thyroid gland in mother during pregnancy;
- irradiation;
- lack of iodine;
- the use by a woman during childbearing of drugs that can inhibit the thyroid gland;
- infectious diseases during pregnancy.
Acquired hypothyroidism can occur at any age for the following reasons:
- injuries of the neck and thyroid gland;
- infectious diseases;
- inflammatory processes in the body;
- lack of iodine;
- autoimmune conditions.
Autoimmune thyroiditis is the cause of subclinical hypothyroidism in children. With this pathology, the thyroid gland is perceived by the body as a source of foreign bodies, which are the increased hormones produced by it. Antibodies of the body begin to neutralize the alleged source of pathology.
Symptoms
Symptoms of hypothyroidism in children vary by age. The older the child, the more severe the symptoms of the disease.
Signs of hypothyroidism in children under one year of age are not very pronounced. It is assumed that this is due to the fact that the child receives the missing hormones with mother's breast milk. Symptoms include:
- delay in childbirth (as a rule, children are born at 41–43 weeks of gestation);
- high fetal weight;
- swelling and blueness of the face;
- swelling of the fingers and tongue;
- the baby breathes heavily and intermittently;
- rude crying;
- dry skin;
- constipation
- jaundice.
In newborns, symptoms may appear that will help to almost unmistakably determine the presence of hypothyroidism. Signs that need to immediately contact a medical institution include:
- noisy breathing;
- cold skin;
- violation of reflexes;
- change in the facial skeleton;
- weak abdominal muscles against the background of its increase;
- head circumference is increased, although height and weight may be within normal limits.
Symptoms become more pronounced with age. But very often, parents miss the onset of the disease, since many of the symptoms are similar to simple fatigue and apathy. The child may be depressed, poorly studying at school. The following symptoms are added to the clinical picture:
- poor appetite;
- teeth erupt with a delay;
- restless sleep;
- observed late closure of the fontanel;
- thin weak hair;
- the child is not interested in the outside world;
- for a long time no attempts have been made to crawl and sit;
- the baby is capricious and makes poor contact with both adults and children;
- heart problems are detected.
With acquired hypothyroidism, symptoms such as
- lethargy;
- drowsiness;
- swelling
- low body temperature;
- low pressure;
- decreased appetite;
- delayed puberty;
- obesity;
- deterioration of the skin;
- mental retardation.
Diagnostics
Diagnostic methods begin to be applied already at the stage of pregnancy, when a woman undergoes a screening analysis, which includes an ultrasound examination of the organs and systems of both the mother and the baby. A blood test for certain hormones is also taken. Therefore, do not neglect screening examinations.
Diagnosis of hypothyroidism in children is carried out in several stages and includes the following procedures:
- The very first method in diagnosis is a screening study of the newborn, which is carried out on about 4-5 days of life. In this case, an analysis is made on the level of the hormone TSH. The diagnosis is made with an increased value.
- For further diagnosis and confirmation of the diagnosis, additional studies are prescribed. First of all, the doctor examines the child and makes an anamnesis of the disease, which takes into account the course of pregnancy, past illnesses, and medications taken.
- Next, a blood test for hormones is performed.
- Ultrasound diagnostics of the thyroid gland is required.
- Sometimes brain tests and ECHO-ECG are required.
- Sometimes scintigraphy may be required.
- Since hypothyroidism necessarily causes abnormalities in the development of the skeletal system, a radiography procedure (usually on the knee joint) is prescribed.
In addition to the clinical aspects of diagnosis, parental monitoring of the condition of the child is very important. At the first signs of the disease, it is necessary to consult a doctor as soon as possible, because the disease in the early stages is successfully treatable.
Treatment
In the treatment of hypothyroidism in children, timeliness and an integrated approach are of great importance. The sooner the disease is diagnosed and therapy is started, the more rapid and effective results will be obtained. Treatment is prescribed by the doctor individually in each case after all diagnostic measures. Unfortunately, the treatment for this diagnosis will be lifelong. But since medicine does not stand still, the pharmacological market provides modern drugs that will help combat the signs of the disease and eliminate the occurrence of complications. Moreover, the quality of life of the child does not deteriorate. He will be able to develop normally both physically and mentally.
With hypothyroidism in children, clinical recommendations include the following:
- Substitution drug therapy. In this case, hormonal preparations are used that replace the missing thyroid hormones. In most cases, L-thyroxine is prescribed , the dosage of which is set individually, depending on various factors - age, weight of the child, severity of the disease, etc. The dosage is changed periodically.
- Reception of vitamins, especially groups A, B, C, E.
- Nootropic drugs (for example, "Piracetam").
- It is also advisable to use dietary supplements that affect the functioning of the thyroid gland. One of them is the drug "Endonorm" made from natural ingredients. Thanks to their effects, the thyroid gland begins to produce the necessary hormones in sufficient quantities. Improvements occur after the first course of admission. In hypothyroidism, treatment with Endonorm in children should take place strictly under the supervision of a doctor, since an overdose of the drug leads to suppression of thyroid function. Allergic reactions to dietary supplement components may also occur.
- With a mild form of the disease, special therapeutic massage or physiotherapy are recommended.
- A special place in the treatment of hypothyroidism is given to diet therapy. It is recommended to consume as much food as possible rich in iodine - seaweed, iodized salt and other foods. Various cereals, fruits and vegetables, and dairy products are also recommended. Everything fatty, floury and salty, including fatty varieties of meat and fish, butter and more, falls under the ban. It is worth limiting fluid intake.
If the disease is found in a newborn child, it is recommended that therapy be carried out in the second week of the child's life.
Hypothyroidism is not treated surgically. This method of exposure is used only in the presence of tumors. After the operation, careful monitoring of the hormonal background and maintenance therapy will be required.
It is worth noting that effective treatment for acquired hypothyroidism can save you from lifelong medication. But constant medical supervision will be necessary.
When confirming the diagnosis, you will need to register with an endocrinologist and a neuropathologist. You may also need to consult a geneticist.
Complications of hypothyroidism
In the absence of timely treatment. serious deviations arise both in mental and physical terms. With hypothyroidism, the consequences for a child can be very dangerous, since the disease develops quickly in young children. One of the most serious complications of hypothyroidism is the following diseases:
- diseases of the cardiovascular system;
- heart attack;
- metabolic disorder;
- arrhythmia;
- delayed ossification;
- diseases of the nervous system;
- cretinism.
But the most dangerous consequence of the development of the disease is hypothyroid coma. This condition, as a rule, occurs in older people under the influence of not only hypothyroidism, but also additional factors - hypothermia, the presence of infections and others. The condition of such a coma is very dangerous for a person, since even with high-quality therapy, death can occur. It is very important to know the first signs of this condition - lethargy, drowsiness, heart rhythm disturbance, severe swelling is observed, body temperature drops to 34 degrees and below. With such symptoms, you must immediately call an ambulance.
Disease Prevention
It is impossible to completely cure hypothyroidism, therefore, it is necessary to carry out preventive measures that should begin already during pregnancy:
- A pregnant woman must undergo all prescribed screening examinations.
- Clarify with the doctor the feasibility of using preparations containing iodine.
- It is forbidden to take drugs that inhibit the thyroid gland and are prohibited during the period of bearing a child.
- Periodically donate blood to thyroid hormones.
- Irradiation of the body is contraindicated.
To prevent the disease in children, it is recommended:
- Eat right, excluding the consumption of fatty foods or rich in simple carbohydrates.
- The child should play sports and more often be in the fresh air.
- Drink vitamins and iodine-containing drugs.
- If the diagnosis is confirmed, it is necessary to support the child in every way emotionally.
- Follow all recommendations and appointments of the attending physician.
Forecast
The prognosis for hypothyroidism depends on many factors. But the most important thing is at what stage of development and at what age the disease was diagnosed. When confirming the diagnosis, the correct treatment regimen for a specific form of hypothyroidism plays a large role in successfully relieving symptoms.
With timely therapy, the chances of a normal life are greatly increased. Often, symptoms are completely eliminated. If the disease was diagnosed at a late stage, there is a high risk of developing pathological conditions, many of which are irreversible.
Conclusion
It is important to understand that hypothyroidism cannot be completely cured, but despite this, early diagnosis and timely treatment will allow children to grow and develop normally. Parents need to be more attentive to the health and behavior of the child and consult a doctor at the first alarming signs. When confirming the diagnosis, you must follow all the instructions of a specialist and surround the baby with care and attention.