TY - JOUR
T1 - Effect of delayed diagnosis and treatment of congenital hypothyroidism on intelligence and quality of life
T2 - An observational study
AU - Pulungan, Aman Bhakti
AU - Oldenkamp, Myrte Everarda
AU - van Trotsenburg, Adrianus Sarinus Paulus
AU - Windarti, Wiwik
AU - Gunardi, Hartono
N1 - Funding Information:
The authors would like to thank Aryono Hendarto as the chairperson of Department of Child Health, Faculty of Medicine, Universitas Indonesia; Jose R. L. Batubara, Bambang Tridjaja, and Frida Soesanti from the Endocrinology Division, Department of Child Health, Faculty of Medicine, Universitas Indonesia; Tjhin Wiguna from the Department of Psychiatry, Faculty of Medicine, Universitas Indonesia; and H. F. Wulandari from Department of Child Health, Faculty of Medicine, Universitas Indonesia for their contribution and support during this study.
Publisher Copyright:
© 2019 Authors.
PY - 2019/12
Y1 - 2019/12
N2 - BACKGROUND Congenital hypothyroidism is one of the most prevalent, albeit preventable causes of intellectual disability. This study determined the intellectual outcome and health-related quality of life (QoL) in children and adolescents clinically diagnosed with congenital hypothyroidism and the associations among age of starting thyroid hormone treatment, current free thyroxine (FT4) level, intelligence quotient (IQ), and QoL. METHODS Intelligence (Wechsler scales) and QoL (PedsQLTM 4.0 parent proxy-report) tests were administered to 25 patients with congenital hypothyroidism in the pediatric clinic of Cipto Mangunkusumo Hospital, Jakarta. Nineteen patients underwent thyroid ultrasonography or scintigraphy to determine the etiology of congenital hypothyroidism. RESULTS A total of 25 patients with the median age of 9 (5.5–12.5) years were recruited. Hemiagenesis of thyroid gland was the most common etiology. Eighteen patients had a total IQ of <70. The age of treatment initiation did not correlate with full scale IQ (FSIQ) (r = −0.261, p = 0.071) and verbal IQ (VIQ) (r = −0.232, p = 0.265). The late initiation of treatment was correlated with lower performance IQ (PIQ) (r = −0.325, p = 0.025). The higher current FT4 levels was correlated with higher scores of FSIQ (r = 0.314, p = 0.046) and PIQ (r = 0.320, p = 0.043). The late initiation of treatment (r = 0.006, p = 0.980) and higher current FT4 levels (r = 0.246, p = 0.310) were not correlated with QoL. CONCLUSIONS The late initiation of thyroid hormone substitution in patients with congenital hypothyroidism negatively affects intellectual abilities.
AB - BACKGROUND Congenital hypothyroidism is one of the most prevalent, albeit preventable causes of intellectual disability. This study determined the intellectual outcome and health-related quality of life (QoL) in children and adolescents clinically diagnosed with congenital hypothyroidism and the associations among age of starting thyroid hormone treatment, current free thyroxine (FT4) level, intelligence quotient (IQ), and QoL. METHODS Intelligence (Wechsler scales) and QoL (PedsQLTM 4.0 parent proxy-report) tests were administered to 25 patients with congenital hypothyroidism in the pediatric clinic of Cipto Mangunkusumo Hospital, Jakarta. Nineteen patients underwent thyroid ultrasonography or scintigraphy to determine the etiology of congenital hypothyroidism. RESULTS A total of 25 patients with the median age of 9 (5.5–12.5) years were recruited. Hemiagenesis of thyroid gland was the most common etiology. Eighteen patients had a total IQ of <70. The age of treatment initiation did not correlate with full scale IQ (FSIQ) (r = −0.261, p = 0.071) and verbal IQ (VIQ) (r = −0.232, p = 0.265). The late initiation of treatment was correlated with lower performance IQ (PIQ) (r = −0.325, p = 0.025). The higher current FT4 levels was correlated with higher scores of FSIQ (r = 0.314, p = 0.046) and PIQ (r = 0.320, p = 0.043). The late initiation of treatment (r = 0.006, p = 0.980) and higher current FT4 levels (r = 0.246, p = 0.310) were not correlated with QoL. CONCLUSIONS The late initiation of thyroid hormone substitution in patients with congenital hypothyroidism negatively affects intellectual abilities.
KW - Congenital hypothyroidism
KW - Etiology
KW - Intellectual disability
KW - Quality of life
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85078244555&partnerID=8YFLogxK
U2 - 10.13181/mji.v28i4.3473
DO - 10.13181/mji.v28i4.3473
M3 - Article
AN - SCOPUS:85078244555
SN - 0853-1773
VL - 28
SP - 396
EP - 401
JO - Medical Journal of Indonesia
JF - Medical Journal of Indonesia
IS - 4
ER -