Hypothyroidism
Hypothyroidism, particularly Congenital Hypothyroidism (CH), is a leading preventable cause of intellectual disability. Early screening and management are paramount.
1. Etiology
| Type | Primary Causes |
|---|---|
| Congenital (CH) | Thyroid dysgenesis (most common, e.g., ectopic gland) and dyshormonogenesis. |
| Acquired | Hashimoto thyroiditis (the most common cause in children/adults). |
2. Clinical Features
- Neonatal: Often asymptomatic due to maternal T4 transfer; may show prolonged jaundice, umbilical hernia, macroglossia, and hypotonia.
- Classic Signs: Cold intolerance, weight gain, constipation, dry skin, bradycardia, and delayed deep tendon reflex relaxation.
3. Diagnosis & Management
- Gold Standard: Elevated TSH and low free T4 (FT4).
- Treatment: Levothyroxine (L-T4) replacement; dose should be titrated to normalize TSH and FT4 levels.
NEET PG Hint: Remember the “5 P’s” of Cretinism: Pot-bellied, Pale, Puffy face, Protruding tongue, and Prolonged jaundice. For acquired cases, Hashimoto thyroiditis is strongly associated with other autoimmune conditions like Type 1 Diabetes and Celiac disease.