Literature Review
Hypothyroidism Facts Sheet
Primary
- 95% of cases
- Congenital hypothryoidism
- Thyroid agenesis
- Dysplasia
- Cretenism affects 1 in 3500 newborns
Acquired primary hypothryoidism
- Hashimoto thyroiditis autoimmune disease--most common cause after age 8
- Teratogenic drug induced
- Iodine deficiency: very common in developing countries
- Radiation destruction
- Surgical removal
- Idiopathic
Secondary
Course of disease
- 5% of cases
- Pituitary or hypothalmic dysfunction
- congenital hypopituitarism
- Pituitary necrosis
Course of disease
- Generalized reduction in metabolic function, most often manifested as slowed physical and mental activity
- In very young infants, it can cause irreversible mental retardation and slowed physical growth
good, with very early treatment, but 3 of 4 infants with hypothyroidism will have lower IQ later in life despite early treatment.
Complications
Diagnosis:
Treatment:
Oral Findings:
Dental management:
Complications
- myxedema coma, mental dysfunction, stupor, cardiovascular collagse
- anemia, dilutional hyponatremia, hyperlipidemia
- impact on growth and development affecting CNS, skeletal, GI, repoductive, etc.
Diagnosis:
- Good med hx and assay of TSH and free T4 levels.
- Congenital usually first found in neonatal screenings, but lab errors--or lack of neonatal screenings could lead to later diagnosis relying on clinical signs.
- Acquired is usually presents with growth deceleration first or maybe goiter
Treatment:
- Depends on underlying cause
- Replacement thyroxine (levothyroxine), orally
Oral Findings:
- enlarged tongue
- delayed dental development and eruption
- malocclusion
- gingival edema
- delayed skeletal development
- protruding tongue and thick lips
Dental management:
- Good medical history
- sensitivity to stress, infection, surgery
- sensitivity to some drugs like sedatives and opioid analgesics
- myxedema coma signs include hypothermia, bradycardia, hypotension, seizures
- consult with physician
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