پاورپوینت کم کاری تيروييد نوزادان (pptx) 49 اسلاید
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تعداد اسلاید: 49 اسلاید
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کم کاری تيروييد نوزادان
Causes of Congenital Hypothyroidism
Developmental defects
1 every 4000 newborns; In Iran >1/1000
Complete absence of thyroid tissue
Failure of thyroid to descend properly during embryologic development
Route of descent (foramen caecum at the junction of anterior two thirds and posterior third of tongue to normal site or below)
Biosynthetic defects in the thyroid
Pituitary or hypothalamic failure
Family with mutation in gene coding TSH β subunit
Thyroid disorders and their approximate prevalence in the neonatal period
Thyroid dysgenesis >1:1000-1:4000
Agenesis
Hypogenesis
Ectopia
Thyroid dyshormonogenesis 1:40,000
Thyroid-stimulating hormone unresponsiveness
Iodide trapping defect
Organification defect
Defect in thyroglobulin
Iodotryrosine deiodinase deficiency
Transient hypothyroidism 1:40,000
Drug induced
Maternal antibody induced
Idiopatic
Hypothalamic-pituitary hypothyroidism 1:100,000
Hypothalamic-pituitary anomaly
Panhypopituitarism
Isolated thyroid-stimulating hormone deficiency
Thyroid hormone resistance
Differential diagnosis of transient congenital hypothyroidism
Primary hypothyroidism
Prenatal or postnatal iodine deficiency or excess
Maternal antithyroid medication
Maternal TSH receptor blocking antibodies
Secondary or tertiary hypothyroidism
Prenatal exposure to maternal hyperthyroidism
Prematurity (particularly <27 weeks’ gestation)
Drugs
Steroids
Dopamine
Miscellaneous
Isolated TSH elevation
Low T4 with normal TSH
Prematurity
Undernutrition
Low-T3 syndrome
Importance of iodine inbrain development
50,000 brain cells produced/secondin developingfetal brain
100 billion brain cells in adult
One million billion connections between these brain cells:Determine IQ
Importance of iodine inbrain development
90 % of human brain development occurs between 3rd month of pregnancy & 3rd year of life(Critical period)
Goiter has been known since the days of Lord Buddha and before
Earliest evidence of goiter: 3000 BC
Cretinism, Tip of the Iceberg
World wide prevalence of goiter