Developmental delay in congenital hypothyroidism

We report the case of a 5-month-old male, born out of a nonconsanguineous marriage, who presented with an inability to hold neck. As per the parents, he had diminished spontaneous movements since birth and described him as lethargic. He was clinically diagnosed with cretinism by a pediatric neurolog...

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Main Authors: Chanan Goyal, Waqar Naqvi
Format: Article
Language:English
Published: The Pan African Medical Journal 2021-02-01
Series:The Pan African Medical Journal
Subjects:
Online Access: https://www.panafrican-med-journal.com/content/article/38/165/pdf/165.pdf
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author Chanan Goyal
Waqar Naqvi
author_facet Chanan Goyal
Waqar Naqvi
author_sort Chanan Goyal
collection DOAJ
description We report the case of a 5-month-old male, born out of a nonconsanguineous marriage, who presented with an inability to hold neck. As per the parents, he had diminished spontaneous movements since birth and described him as lethargic. He was clinically diagnosed with cretinism by a pediatric neurologist. He was referred by to the department of physiotherapy for evaluation and advice for the associated motor delay. On observation, the infant displayed peculiar clinical features of sparse hair, periorbital edema and macroglossia (A). Irritability, hoarse cry, abdominal distension and frog leg position was observed in supine lying position (B). Examination revealed generalized hypotonia, wide fontanelles, feeding difficulties and global developmental delay. He was neither able to roll over from supine to prone nor was he able to hold neck adequately. He had head lag during pull to sit test. Due to financial constraints, they were not willing to attend physiotherapy sessions on a regular basis. Thus, parents were educated about the home exercise program that included active assisted rolling, neck extensor muscles facilitation against gravity while lying prone on forearm, active assisted reaching out for objects while lying, neck flexor muscles facilitation in gravity minimized plane and active neck rotations to look at objects of interest while side lying on forearm support. Congenital hypothyroidism is still a common cause of developmental delay in newborns of the developing countries. Awareness, universal newborn screening, prompt recognition and medical treatment along with physiotherapy can minimize adverse effect on the physical and neurocognitive development.
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spelling doaj.art-6e23c685b9ce462683279d1b42814f2c2022-12-21T18:35:25ZengThe Pan African Medical JournalThe Pan African Medical Journal1937-86881937-86882021-02-013816510.11604/pamj.2021.38.165.2732127321Developmental delay in congenital hypothyroidismChanan Goyal0Waqar Naqvi1 Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India We report the case of a 5-month-old male, born out of a nonconsanguineous marriage, who presented with an inability to hold neck. As per the parents, he had diminished spontaneous movements since birth and described him as lethargic. He was clinically diagnosed with cretinism by a pediatric neurologist. He was referred by to the department of physiotherapy for evaluation and advice for the associated motor delay. On observation, the infant displayed peculiar clinical features of sparse hair, periorbital edema and macroglossia (A). Irritability, hoarse cry, abdominal distension and frog leg position was observed in supine lying position (B). Examination revealed generalized hypotonia, wide fontanelles, feeding difficulties and global developmental delay. He was neither able to roll over from supine to prone nor was he able to hold neck adequately. He had head lag during pull to sit test. Due to financial constraints, they were not willing to attend physiotherapy sessions on a regular basis. Thus, parents were educated about the home exercise program that included active assisted rolling, neck extensor muscles facilitation against gravity while lying prone on forearm, active assisted reaching out for objects while lying, neck flexor muscles facilitation in gravity minimized plane and active neck rotations to look at objects of interest while side lying on forearm support. Congenital hypothyroidism is still a common cause of developmental delay in newborns of the developing countries. Awareness, universal newborn screening, prompt recognition and medical treatment along with physiotherapy can minimize adverse effect on the physical and neurocognitive development. https://www.panafrican-med-journal.com/content/article/38/165/pdf/165.pdf congenital hypothyroidismcretinismdevelopmental delay
spellingShingle Chanan Goyal
Waqar Naqvi
Developmental delay in congenital hypothyroidism
The Pan African Medical Journal
congenital hypothyroidism
cretinism
developmental delay
title Developmental delay in congenital hypothyroidism
title_full Developmental delay in congenital hypothyroidism
title_fullStr Developmental delay in congenital hypothyroidism
title_full_unstemmed Developmental delay in congenital hypothyroidism
title_short Developmental delay in congenital hypothyroidism
title_sort developmental delay in congenital hypothyroidism
topic congenital hypothyroidism
cretinism
developmental delay
url https://www.panafrican-med-journal.com/content/article/38/165/pdf/165.pdf
work_keys_str_mv AT chanangoyal developmentaldelayincongenitalhypothyroidism
AT waqarnaqvi developmentaldelayincongenitalhypothyroidism