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Neurologic Outcome in Congenital Hypothyroidism.

Journal of the Korean Pediatric Society 1988;31(7):901-913.
Published online July 31, 1988.
Neurologic Outcome in Congenital Hypothyroidism.
Byeung Ju Jeoung1, Duk Hi Kim1, Chang Jun Coe1, Hang Cho Kang2
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Chungbuk Rehabilitation Center for Mentally Retarded, Cheongju, korea
선천성 갑상선 기능저하증의 신경학적고찰
정병주1, 김덕희1, 고창준1, 강홍조2
1연세대학교 의과대학 소아과학교실
2사회복지법인 충북재활원
Received: 5 December 1987   • Accepted: 10 February 1988
Abstract
Congenital hypothyroidism is one of the most common endocrine disease in childhood and is a major cause of mental retardation. It is clear that the earlier treatment is started, the better intellec- tual potential and the likely absence of neurological sequellae. The present study was carried out to try to define the incidence and the nature of the neurologic disorders and to examine the factors which influenced intellectual development. We evaluated 31 patients with congenital hypothyroidism at Yonsei University College of Medicine during 13 years from September, 1972 to September, 1985. The results were summerized as follows 1) Amoug 31 patients with congenital hypothyroidism thyroid dysgenesis was 22 cases (71%), which included 12 cases of ectopic thyroid gland, 6 cases of thyroid aplasia and 4 cases of thyroid hypoplasia, and there were 9 cases (29%) of thyroid dyshormonogenesis. 2) We evalualed the age distribution at the time of diagnosis. There were 5 cases under age of 1 year, 14 cases between 1 and 5 years, 12 cases above age of 5 years. 3) The male to female ratio was 1:1.4. 4) The IQ distribution of congenital hypothyroidism showed normal (IQ above 84) in 12 cases, borderline (IQ68-83) in 7 cases and retarded (IQ below 67) in 8 cases. 5) There was a significant correlation between mental development and serum T3, T4, TSH level at the time of diagnosis and age at the time of initial treatment. 6) Thyroid aplasia revealed the lowest serum T3, T4, level and the highest TSH level at the time of diagnosis. 7) The neurologic defects was found in 65% and outcome was the poorest in patient of thyroid aplasia.
Key Words: Congenitial hypothyroidism, Neurologic outcome1987


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