Clinical context of the thyroid gland development and its disorders in the fetus and newborn (part 2)
Authors:
D. Neumann 1; K. Krylová 1; E. Al Taji 2; Z. Límanová 3; P. Dejmek 2; J. Horáček 4
Authors place of work:
Dětská klinika LF UK a Fakultní nemocnice, Hradec Králové
přednosta prof. MUDr. M. Bayer, CSc.
1; Klinika dětí dorostu UK 3. LF a Fakultní nemocnice Královské Vinohrady, Praha
přednosta doc. MUDr. F. Votava, CSc.
2; III. interní klinika UK 1. LF a Všeobecné fakultní nemocnice, Praha
přednosta prof. MUDr. Š. Svačina, DrSc.
3; IV. interní klinika LF UK a Fakultní nemocnice, Hradec Králové
přednosta doc. MUDr. P. Žák, Ph. D.
4
Published in the journal:
Čes-slov Pediat 2013; 68 (5): 331-341.
Category:
Review
Summary
This survey article connects physiology of anatomical and functional development of thyroid gland (including genetic influence during thyroid morphogenesis and hormonogenesis) with newborn care. Disorders of thyroid development and function may lead to congenital hypothyroidism, which, unless treated in due time, causes irreversible impairment of child´s development, especially in the area of neurocognitive functions. A functioning newborn screening programme can prevent mental and other impairments by early diagnosing hormone levels and enabling a timely start of an appropriate term newborn treatment with L-thyroxine. Mild forms of thyroid dysgenesis and dyshormonogenesis which can be functionally asymptomatic at birth may not show during newborn screening. Later on, they develop into non-immune based hypothyroidism or they can occur in families with congenital hypothyroidism. In case of newborn hyperthyrotropinemia, management strategy should be based on TSH levels during week 2 after delivery. Therapy guidelines for transient hypothyroxinemia of prematurity are still being discussed. Triiodothyronine substitution is recommended in newborns with a prolonged course of a severe disease and if the sick euthyroid syndrome is proved. If the therapy is not indicated, children should be included in a long-term follow-up programme.
Key words:
newborn, thyroid hormones, congenital hypothyroidism, dysgenesis, dyshormonogenesis, genes, hypothyroxinemia of prematurity, newborn hyperthyreotropinemia
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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