Karnataka: Doctors want govt to mandate hypothyroidism test for newborns

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What is congenital hypothyroidism?

Congenital hypothyroidism (CHT) is a condition resulting from an absent or under-developed thyroid gland (dysgenesis) or one that has developed but cannot make thyroid hormone because of a ‘production line’ problem (dyshormonogenesis). Babies with CHT cannot produce enough thyroid hormone for the body’s needs. The term ‘congenital’ means that the condition is present at birth.

What causes congenital hypothyroidism and is it inherited?

  • Very early in an unborn baby’s development the thyroid gland moves from the back of the tongue to its normal position in the neck. In some babies this fails to occur and the gland does not develop at all.
  • In others it is higher in the neck than normal and does not work as well as it should. Dysgenesis is the term that is often used to describe these forms of CHT.
  • Around 80% of babies with CHT have dysgenesis and the risk of a couple having another child with this kind of CHT is low. The more uncommon type, dyshormonogenesis, affects around 20% of babies with CHT.
  • The gland is in the right position but does not produce thyroxine normally because of a ‘production line’ problem. This type can be inherited and there is a risk that the baby’s siblings will also be affected.

Why in News

  • Two weeks ago, a dwarf girl was carried in her mother’s arms into a private clinic in Yelahanka. She wasn’t a toddler. She was 21 years old.
  • At the first look, the doctor was able to determine what led to the stunted growth. It was congenital hypothyroidism: a rare disease that can be diagnosed with a simple blood test that costs less than Rs 100. Had she been diagnosed at birth, the girl would have led a normal life, said Dr Praveen Ramachandra, director, DiaPlus Clinic, Yelahanka.
  • Many children like her have hypothyroidism-associated disorders that can be treated if diagnosed early. Paediatricians, obstetricians and gynaecologists want the Karnataka government to make it mandatory that all newborns are screened for possible hypothyroidism.
  • Addressing a press conference on Tuesday, they said they would soon petition the state and Union governments in that regard.
  • Dr Mala Dharmalingam, professor and head, endocrinology, MS Ramaiah Medical College, said a national-level committee would soon make representations to the government about making hypothyroidism screening mandatory for newborns. “In all corporate hospitals, this screening is done. There is no reason why government hospitals should not do it,” she said.
  • The screening, which costs just Rs 60-100, can improve many lives. “If the child is screened at birth and treatment begins soon after, morbidities can be avoided,” Dr Dharmalingam said. Hypothyroidism in children can cause mental retardation, stunted growth, lower IQ, hair fall and dry skin, among other complications.
  • Dr Anjana Hulse, consultant paediatric endocrinologist, Apollo Hospitals, said congenital hypothyroidism could be of two kinds. In primary hypothyroidism, the thyroid gland is absent, located elsewhere or is existent but non-functional.
  • In secondary hypothyroidism, the pituitary gland does not send messages for the secretion of thyroid hormones. “It could be multi-factorial or genetic,” she said.
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