الفهرس 
Thyroid GlandOnly 14 pages are availabe for public view
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Abstract
Congenital hypothyroidism (CH) is the most common preventable causes of mental retardation in children. Thyroid dysgenesis is the most common cause of CH accounting for approximately 85% of all cases. Early treatment and high compliance to therapy is an important prognostic factor for normal neurodevelopment in children with CH.
Aim of the Study: The study aim to assess the compliance to therapy in cases of congenital hypothyroidism and its effect on neurodevelopment outcome.
Subjects and Methods: The study was prospective, conducted in Endocrinology and Pediatric Outpatient Clinics in Benha Children Hospital Al-Qalyopia Governorate. The study participants were 50 newborn and infant with CH and their mothers (patients group), and 50 age matched volunteers of healthy infants and children and their mothers (control group). Data were collected to determine socioeconomic state, clinical picture at presentation, personal, family and obstetric history and Morisky Medication Adherence Scale (MMAS 8) to assess patient compliance. Assessment of physical growth through the anthropometric measurements and assessment of neurodevelopment by using Vineland-II scale. The results of investigations at diagnosis (initial TSH and T4) and bone age and during the follow up visits were reviewed.
Results: About 64% of cases were permanent CH and about 14% of cases were transient CH. The most common cause of CH was thyroid dysgenesis (74%) followed by dyshormonogenesis (16.8%) and antithyroid drug intake (11.1%) About three quarters (74%) of patient families were moderate to highly compliance to therapy while 26% showed low compliance to therapy. About half of patient had mild form of CH. Bone age at diagnosis of CH was delayed in almost half of the patients. The most significant factors affecting the compliance were residence, social class and presence of symptoms at presentation and congenital malformations. There was statistical significant negative correlation between compliance score and severity of intrauterine hypothyroidism by bone age and severity level of CH according to the initial FT4 levels, length of normalization period of TSH, TSH level at the start of the study and initial L thyroxine dose and highly significant negative correlation between the compliance score and the follow up TSH level after three and six months, severity level of CH and Length of normalization period of TSH. There was significant positive correlation between compliance score and the parameters of the physical and neurological development.
Conclusions: Sixty four % of cases were permanent CH. Compliance to L thyroxin therapy in our patients and/or their family.