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Language disorders in children with congenital hypothyroidism
The Egyptian Journal of Otolaryngology volume 33, pages685–690(2017)
Congenital hypothyroidism (CH) represents one of the most common preventable causes of mental retardation. If fetal hypothyroidism develops, untoward effects may be shown in certain organ systems, including the central nervous system. CH may be associated with hearing and language impairment. It is possible that this impairment may worsen with delay of therapy. Problems in language, auditory processing, and reading may persist in hypothyroid children, particularly if their treatment with l-thyroxin is delayed into the third week of life.
The aim of this study is to estimate the extent of language disorder and detect the factors influencing language acquisition in children with CH.
Patients and methods
This study included 60 children. The study group included 40 children who complained of CH. The age range of this group was 3–8 years. The children of the study group were divided according to the level of thyroid stimulating hormone (TSH) and T4 into two subgroups. The G1 subgroup included children with controlled CH and subgroup G2 included children with uncontrolled hypothyroidism. The results of the study group were compared with those of another group (control group), which included 20 children; both groups were matched for age and sex. The children of both groups were subjected to the protocol of language assessment.
Results and conclusion
The current study showed that the children with uncontrolled CH show delayed language, mental, social age, and intelligence quotient in comparison with children with controlled hypothyroidism and normal children.
There is a need for the diagnosis and treatment of children with CH as soon as possible after birth, preferably no later than the second week of life. It is also important to screen hypothyroid children for hearing problems and to provide remediation in language and reading.
Kliegman E, Behrman D, Jenson F. Nelson text book of pediatric. Vol. 5. 17th edn. Noble: Barnes; 2007.122–160.
Rovet J, Daneman D. Congenital hypothyroidism: a review of the current diagnostic and treatment practices in relation to neuropsychologic outcome. Paediatr Drugs 2003; 5:141–149.
Fuggle PW, Grant DP, Smith I. Intelligence, motor skills and behavior at 5 years in early treated congenital hypothyroidism. J Pediatr 1988; 15:570–574.
Rovet J, Ehrlich R, Sorbara D. Intellectual outcome in children with fetal hypothyroidism. J Pediatr 1987; 110:700–704.
Rovet JF, Ehrlich RM. Long-term effects of L-thyroxine therapy for congenital hypothyroidism. J Pediatr 1995; 126:380–386.
Terman LM, Merril MA. Stanford Binet intelligence scale. Boston: Houghton Mifflin Company; 1972; 8:100–203.
Snijders-Omnen JA. Nonverbal intelligence test for deaf and hearing subjects. Holland: J.B. Wolters; 1939; 2:55–99.
Doll EA. Vineland social maturity scale Vol. 2. USA: Minneapolis American Services; 1965. p. 99–200.
Kotby MN, Khairy A, Baraka M, Rifaie N, El Shobary A. Language testing of Arabic speaking children. Proceeding of the XXIII world congress of International Association of Logopedics and Phoniatrics; Cairo; 5 August 1995; p. 6–10.
Zakarajia M, Mckenize JM, Eidson MS. Transient neonatal hypothyroidism: characterization of maternal antibodies to the thyrotropin receptor. J Clin Endocrinol Metab 1990; 70:1239–1245.
Bernal J, Nunez J. Thyroid hormones and brain development. Eur J Endocrinol 1995; 133:390–398.
Miller KJ, Parsons TD, Whybrow PC, van Herle K, Rasgon N, van Herle A, et al. Memory improvement with treatment of hypothyroidism. Int J Neurosci 2006; 116:895–906.
Koibuchi N, Chin W. Thyroid hormone action and brain development. Trends Endocrinol Metab 2000; 11:123–128.
Hrytsiuk I, Gilbert R, Logan S, Pindoria S, Brook CG. Starting dose of levothyroxine for the treatment of congenital hypothyroidism: a systematic review. Arch Pediatr Adolesc Med 2002; 156:485–491.
Alves C. Changes in brain maturation by magnetic resonance imaging in congenital hypothyroidism. J Pediatr 2004; 115:6000–6003.
Glorieux J, Desjardins M, Letarte J, Morissette J, Dussault JH. Useful parameters to predict the eventual mental outcome of hypothyroid children. Pediatr Res 1988; 24:6–8.
Denman SB. Neuropsycology memory scale. Charleston, SC: Springer; 1984.
Komur M, Ozen S, Okuyaz C, Makharoblıdze K, Erdogan S. Neurodevelopment evaluation in children with congenital hypothyroidism by Bayley-III. Brain Dev 2013; 35:392–397.
Gejão MG, Lamônica DA. Development skills in children with congenital hypothyroidism: focus on communication. Pro Fono 2008; 20:25–30.
Bargagna S, Astrea G, Perelli V, Rafanelli V. Neuropsychiatric outcome in patients with congenital hypothyroidism precautiously treated: Risk factors analysis in a group of patients from Tuscany. Minerva Pediatr 2006; 58:279–287.
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Mohamed, H.M., Zaki, E., Abdall, A.A.B. et al. Language disorders in children with congenital hypothyroidism. Egypt J Otolaryngol 33, 685–690 (2017). https://doi.org/10.4103/1012-5574.217383
- language development