Overview
Treatment consists of thyroid hormone supplementation but in children with long standing hypothyroidism, catch up growth may be incomplete.
The thyroxine initially should be replaced in low doses followed by gradual increase in the dose till euthyroid state is achieved and keeping the child on maintenance dose to decrease incidence of pseudotumor cerebri and cardiac failure.
During the first year deterioration of school work, poor sleeping habits, restlessness and behavioral problems may occur but it is transient and partially ameliorated by starting at sub replacement supplementation and increasing slowly.
Causes
- Acute suppurative thyroiditis is more common in poorer geographic areas where antibiotic use is less prevalent. It usually occurs in children with embryologic abnormalities such as a persistent thyroglossal duct or brachial cleft cysts.
- Chronic autoimmune thyroiditis is more common in developed countries with increased iodine intake.
- Children with Down syndrome or Turner syndrome and those who have type 1 diabetes or another autoimmune endocrine disease are at particular risk of chronic thyroiditis.
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