ESPE Abstracts

Objective: To evaluate clinical features, etiology and evolution of patients with hypothyroidism.

Methods: Longitudinal retrospective study of patients diagnosed with hypothyroidism between 2004 and 2019. Study was conducted in the west of Algiers. Age at diagnosis, clinical characteristics and initial dose of treatment were recorded. Patients were classified according to etiology. In congenital hypothyroidism, neurocognitive assessment was based on intelligence quotient (IQ).

Results: 74 cases were identified: 42 F/32 M, the patient’s average age at diagnosis was 9 (range 0.1-144) months in congenital hypothyroidism, and 7 (range 1-15) years in acquired hypothyroidism. Consanguinity was present in 8 (11%) of cases, with a family history of thyroid disease in 28 (38%). In congenital hypothyroidism (25 cases), appearing symptoms were jaundice (11 cases), constipation (4 cases), delayed development (5 cases: late diagnosis) and others (4 cases). In acquired hypothyroidism (49 cases), the majority of patients were asymptomatic (diabetes and Down syndrom screening: 44 cases), 2 cases had short stature, 2 cases had delayed puberty. In the laboratory evaluation, we highlight: high TSH in all patients, low free T4 in 96 %, 3 patients had a subclinical hypothyroidism; elevated title of antiperoxidase were found in 40 patients. There were 25 patients with congenital hypothyroidism: 2 cases of Down syndrome, 11 cases of gland in situ. 40 patients who had Hashimoto's thyroiditis presented type1 DM, and 9 patients had Down syndrome. Majority of patients received L-thyroxin (96%) and mean age to start it in congenital hypothyroidism was 9 (range 0.1-114) months. Among re-evaluated patients (13 cases), 9 cases had permanent hypothyroidism at 3 years.

Conclusion: Many etiologies can be at the origin of hypothyroidism. It’s important to distinguish the congenital from the acquired. The permanent congenital hypothyroidism is the commonest treatable cause of learning difficulties. The diagnosis remains late in our country, the only alternative is the screening facilities. Management and prognosis depend on etiology.