Pediatric practitioners must consider the possibility of thyroid disorders as they evaluate their patients. Investigators have now provided a concise review of diagnostic and treatment recommendations. Highlights are as follows:
Congenital hypothyroidism
Newborns are usually asymptomatic.
False-positive newborn screens can occur if obtained <48 hours following birth.
Acutely ill and high-risk newborns should be screened 2 to 6 weeks postnatally.
Ultrasonography can identify hypoplasia, but thyroid scintigraphy is the best imaging study to find ectopic tissue.
Thyroid replacement therapy should begin at ≤2 weeks of age.
Acquired hypothyroidism
Hashimoto thyroiditis is the most common cause in the U.S.
Iodine deficiency is the most common cause globally.
Fatigue, cold intolerance, constipation, and menstrual irregularities are common symptoms.
A goiter is the most common physical finding.