Endocrine Abstracts

JOINT217

Background: Congenital hypothyroidism (CH) is a leading cause of preventable intellectual disability and growth failure. Early detection and initiation of thyroxine therapy are crucial for optimizing neuropsychological and physical outcomes. The timing of treatment initiation and initial thyroxine (T4) levels significantly influence neurocognitive and physical development in children with CH^1,2.

Methods: A cross-sectional study was conducted at a tertiary care hospital from January 2017 to December 2018. Sixty children aged >3 years with CH were evaluated using the Binet Kamat Scale for Intelligence to assess IQ³ and the Child Behavior Checklist (CBCL) to measure behavioral outcomes, including Withdrawal, Anxiety/Depression, Social Problems, Thought Problems (WAST), Attention Deficit, and Aggression (ADA). Height SDS (standard deviation score) was recorded. Statistical analysis was performed using SPSS v20, with a p-value < 0.05 considered statistically significant.

Results: Females constituted 53% of the study cohort, while males (47%) exhibited more severe biochemical abnormalities (lower T4 and higher TSH levels at diagnosis). IQ was significantly influenced by the timing of therapy initiation: children treated within the first month of life had a mean IQ of 79, compared to 59.5 for those treated between 1 and 6 months, and 61.1 for those treated after 6 months. Severe CH, indicated by lower T4 levels, was associated with greater IQ deficits. Height SDS and behavioral scores (WAST and ADA) showed no significant correlation with therapy timing, though elevated WAST and ADA scores were observed.

Conclusions: Early initiation of thyroid hormone therapy (<1 month) significantly improves IQ in children with CH. However, the timing of therapy does not appear to impact height SDS or behavioral outcomes. These findings highlight the importance of neonatal screening and timely intervention to improve neurocognitive outcomes^1,3..

Keywords: Congenital Hypothyroidism, Neuropsychiatric development.

References: 1. Léger J, Olivieri A, Donaldson M, et al. European Society for Paediatric Endocrinology guidelines for congenital hypothyroidism management. Horm Res Paediatr. 2014;81(2):80-103.

2. Rovet JF. The role of thyroid hormones for brain development and cognitive function. Endocr Dev. 2014;26:26-43.

3. Kamat VV. Measuring Intelligence of Indian Children. Bombay: Oxford University Press; 1967.