Effect of delayed diagnosis and treatment of congenital hypothyroidism on intelligence and quality of life: an observational study

  • Aman Bhakti Pulungan Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Myrte Everarda Oldenkamp Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands https://orcid.org/0000-0002-8980-6662
  • Adrianus Sarinus Paulus van Trotsenburg Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
  • Wiwik Windarti Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Hartono Gunardi Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-9274-5146
DOI: https://doi.org/10.13181/mji.v28i4.3473
Keywords: congenital hypothyroidism, etiology, intellectual disability, treatment, quality of life
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Abstract

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. 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. Hemiagenesis of thyroid gland was the most common etiology.
CONCLUSIONS The late initiation of thyroid hormone substitution in patients with congenital hypothyroidism negatively affects intellectual abilities.

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Published
2019-12-13
How to Cite
1.
Pulungan AB, Oldenkamp ME, van Trotsenburg ASP, Windarti W, Gunardi H. Effect of delayed diagnosis and treatment of congenital hypothyroidism on intelligence and quality of life: an observational study. Med J Indones [Internet]. 2019Dec.13 [cited 2024Jul.3];28(4):396-01. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/3473
Issue
Vol. 28 No. 4 (2019): December
Section
Brief Communication

Copyright (c) 2019 Aman B. Pulungan, Myrte Oldenkamp, A.S. Paul van Trotsenburg, Hartono Gunardi

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