Hipotiroidismo congénito : inicio del tratamiento con levotiroxina después del diagnóstico inicial por cribado neonatal para la evaluación del riesgo de retraso en el neurodesarrollo; servicio de endocrinología del hospital del niño Dr. Francisco De Icaza Bustamante, periodo 2015 – 2022.

Abstract

Background: it is considered that neurodevelopmental delay in patients with congenital hypothyroidism depends directly on the initiation of the treatment with Levothyroxine, so that, in order to avoid neurological damage, reduce morbidity and mortality and associated disabilities, there is a neonatal screening program worldwide. Methodology: observational, retrospective, transverse, analytical, relational, cohort, made in patients from 1 month to 15 years served with the diagnosis of congenital hypothyroidism at the Hospital del Niño Dr. Francisco de Icaza Bustamante. Results: a total of 136 files were analyzed, 115 cases were selected that met the inclusion criteria, a proportion of 3:1 was found in female relationship: male, the comorbidity found more frequently was Down syndrome, reported in 24.7 %, likewise, the diagnosis was made with a median of 43.5 days of life, that is, within studies the presence of initial TSH had a median of 145 uIU/ml, only one patient was found with hypothyroidism of central cause; a median Age at the start of treatment was evidenced at 45 days of age. The time between the diagnosis and the initiation of treatment was a median of 0 days and a mean of 8 days. In 50.1% of patients, they presented neurodevelopmental delay. It was found that the age of life at the time of diagnosis of patients with neurodevelopment delay was above 40 days of life, that is, at 47 days of life, they already have a certain degree of neurodevelopment delay with a P of 0.015. It was evidenced that at a longer the time of initiation of treatment, the greater the mental retardation presented by patients. Conclusions: patients who had been able to start treatment for more than 47 days have some degree of intellectual disability. It is verified that there is indeed a determination of the start of treatment with levothyroxine after the positivity of neonatal screening in patients with a diagnosed of congenital hypothyroidism of the endocrinology service at the Hospital del Niño Dr. Francisco de Icaza Bustamante.