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Congenital hypothyroid: Growth Disorders


Congenital hypothyroid

In outline the growing disorders in congenital hypothyroid is as follows:
Disruption of physical growth.
Congenital hypothyroidDeficiency of thyroid hormone, which occurred during the end of the fetus (THIRD Trimester of pregnancy) and neonatal, would cause the child undergoes body shape, so that the child be retardation dwarf. This is because:
a. Low metabolisms, nitrogen retention is reduced, and most of the functions of the organs under the normal system.
b. bone Tissue is still not mature/immature because of the reason of maturasi epiphyseal, resulting in the reason of growth of long bones – Congenital hypothyroid. Similarly the growth of bone of the skull and the closure of the cranial bones sutura will experience delays, so the cantle late closing.
Initially it is said that both the T3 and T4 are not able to pass through the placenta, but nowadays it is known that this hormone can pass the placenta though in number of earners. So before the fetal thyroid gland function, some should be assisted from the mother. This can be proven that only about 60-70% of cases there are disorders of bone maturasi.
Vulsma 1989 (quoted from Djokomoelyanto 1993), proving that thyroid hormone can mother through the placenta. Instead of 17.5% thyroid hormone fetus from maternal. Mediators of the effect of maternal thyroid hormone (although in a bit), on children’s brain development is thought through “growth factors”, such as: nerve growth factor, epidermal growth factor, insulin-like growth factor.
Disorders of growth and maturity of the CNS.
Congenital hypothyroid can cause delays that blatant on CNS: this is caused due to the growth and arborisation of the nerve cells too late, the interaction and connectivity are reduced, axodendritic vascularization and mielinizacion occurred at a speed below normal. There are mental retardation with/without hearing loss perceptive types until deaf-mute, neuromotor disorder such as disruption of talk, how strange the way cannot be restored, occur if treatment is delayed. Period of dependence of CNS against thyroid hormone takes place starting from pregnancy until the age of 2-3 years.
According to Porterfield 1993, essentially against thyroid hormone dependence CNS from a fetus until birth is divided into three phases, namely:
1. Phase I, 10-12 week gestation period before development of thyroid hormone produced by the fetus (the source was from the mother). In this case the development phase of the brainstem, specifically the migration of neurons and peripheral neurogenesis.
2. Phase II period of thyroid hormone producing fetus.
In this phase of the growth of the brain affected by thyroid hormone derived from the fetus and may also be of the mother. Where does maturasi neuron, Synapse formation, the development in neurit forebrain.
3. phase III period after birth.
The brain is dependent only on the hormones produced by neonatal EEG. In this phase, the cerebellum, neuron proliferation migration and differentiation occur, whether unaccompanied on phase II and III however gliogenesis and mielinisasi special on phase III.
Disruption of the process of maturity (Puberty) .
If a sufferer is not treated, then there will be a failure of sexual growth or growth of the sex is too late and not perfect (sexual infantilism). On the larger sufferers is amenorrhea/impaired spermatogenesis.
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