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Juvenile Myxedema

Hypothyroidism Juvenile


Presentation

  • Abstract A FREQUENT presenting sign of hypothyroidism in children is short stature. Failure to grow may be a manifestation of hypothyroidism due to pituitary malfunction or to primary thyroid failure.[mdedge.com]
  • Other findings of hypothyroidism like loss of eyebrows, calf muscle hypertrophy, dry skin, and delayed relaxation of reflexes were also present.[thetrp.net]
  • Theoretically, the causes of abnormalities present at birth can be listed as of a genetic, germinal or peristatic nature. During the past decades special attention has been paid to both genetic and peristatic factors.[books.google.com]
  • UPDATED coverage reflects current research relating to accuracy of testing, diagnostic values of results, and the patient care and education associated with each test. 14 NEW test entries present the latest tests and procedures with an emphasis on new[books.google.com]
  • In one a thymoma was present, in three the gland was hyperplastic and in two it was atrophied.[docslide.com.br]
Goiter
  • MORPHOLOGY OF THE PITUITARY 19 THE OPTIC CHIASM IN ENDOCRINOLOGIC 204 PARANEOPLASTIC ENDOCRINE 223 SEX HORMONES AND HUMAN 219 APPROACH TO THE PATIENT WITH 37 ADVERSE EFFECTS OF IODIDE 360 MORPHOLOGY OF THE THYROID 38 NONTOXIC GOITER 366 SYNTHESIS AND[books.google.com]
  • In food animals the syndrome is classical neonatal colloid goiter. See also goiter . autoimmune hypothyroidism congenital hypothyroidism results from congenital thyroid dysgenesis, defective hormone synthesis or severe iodine deficiency.[medical-dictionary.thefreedictionary.com]
  • Iodine Deficiency Goiter: Subiodic goiter; Simple goiter; colloid goiter - pubertal, Adolescent Gestational; Menopausal; Endemic; Sporadic. 4. Hypothyroidism" Adult myxedema; Cretinism; Juvenile myxedema. 5.[homeoint.org]
  • Over 60% presented for goiter, 10% with pain in the thyroid region.[indianpediatrics.net]
  • Uninodular goiter (nontoxic) 241.1 Nontoxic multinodular goiter Multinodular goiter (nontoxic) 241.9 Unspecified nontoxic nodular goiter Adenomatous goiter Nodular goiter (nontoxic) NOS Struma nodosa (simplex) 242 Thyrotoxicosis with or without goiter[theodora.com]
Hypothermia
  • . - decreased cardiac output - cerebral hypoxia - stupor - hypothermia - bradycardia - hypotension.[quizlet.com]
  • American Association of Clinical Endocrinologists (AACE) advocates the use of a high-quality brand preparation of levothyroxine High mortality rate Myxedema coma almost always occurs in the elderly non compliance with hypothyroid treatment *Extreme hypothermia[quizlet.com]
  • […] blood sugar (hypoglycemia) , common in insulin-dependent diabetics after an exercise, skipped meal or insulin overdose Blood loss due to external or internal bleeding (in car accidents , shooting or stitch injuries), heavy menstrual bleeding, surgery Hypothermia[ktthebest4u.blogspot.com]
  • Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypoglycemia, hypotension, respiratory depression, and coma. Cause [ edit ] Myxedema is known to occur in various forms of hypothyroidism , and also in Graves' disease .[en.wikipedia.org]
  • Usually occurs in elderly patients and presents with confusion, severe hypothermia, shock and coma.[flexikon.doccheck.com]
Constipation
  • Since infancy she had had a problem with constipation, which had been controlled with diet. Her skin had always been quite dry. Her medical history and review of systems were otherwise non-contributory.[mdedge.com]
  • Regular exercise and a high-fiber diet can help maintain thyroid function and prevent constipation.[medical-dictionary.thefreedictionary.com]
  • Geography of hypothyroidism Incidence is ten times higher than average in iodine-deficient areas *places where there is excessive consumption of goitrogens (e.g. cassava) Symptoms of hypothyroidism Tiredness, weakness Dry skin Feeling cold Hair loss Constipation[quizlet.com]
  • They may have difficulty feeding and experience constipation. If untreated, congenital hypothyroidism can lead to intellectual disability and slow growth.[icdlist.com]
  • He had history of growth arrest, weight gain, puffiness of face and constipation since the age of 8 years.[thetrp.net]
Macroglossia
  • There is dwarfism, macroglossia and mental dullness. iatrogenic hypothyroidism may follow treatment for hyperparathyroidism in cats. juvenile hypothyroidism congenital hypothyroidism (above). primary hypothyroidism that resulting from disease of the thyroid[medical-dictionary.thefreedictionary.com]
  • Symptoms Feeding difficulties Somnolence Lethargy Low frequency of crying Constipation Signs Large fontanelles Myxoedema - with coarse features and a large head and oedema of the genitalia and extremities Nasal obstruction Macroglossia Low temperature[patient.info]
  • ORAL MANIFESTATIONS Symptoms  Teeth  Jaw bone  Palate  Macroglossia  Lips Radiological features  Skull changes  Air sinuses  Teeth  Jaw bone 11.    Surgery- trans sphenoidal surgery may result in cure of growth hormone excess especially in[slideshare.net]
Coarseness of the Skin
  • In addition to a decreased metabolic rate, symptoms may include anemia, slow speech, an enlarged tongue, puffiness of the face and hands, loss of hair, coarse and thickened skin, and sensitivity to cold.[medical-dictionary.thefreedictionary.com]
Somnolence
  • Cf Hyperthyroidism . hy·po·thy·roid·ism ( hī'pō-thī'royd-izm ) Diminished production of thyroid hormone, leading to clinical manifestations of thyroid insufficiency, including somnolence, slow mentation, dryness and loss of hair, subnormal temperature[medical-dictionary.thefreedictionary.com]
  • […] hypothyroidism Depression Cognitive problems Weight gain Fatigue Irregular menstruation Infertility Gastrointestinal disease Hyperlipidemia Coronary artery disease Hypertension Neonatal/congenital hypothyroidism Prolonged jaundice Hoarse cry Constipation Somnolence[quizlet.com]
  • Symptoms Feeding difficulties Somnolence Lethargy Low frequency of crying Constipation Signs Large fontanelles Myxoedema - with coarse features and a large head and oedema of the genitalia and extremities Nasal obstruction Macroglossia Low temperature[patient.info]
  • Signs and symptoms of hypothyroidism include low metabolic rate, tendency to weight gain, somnolence and sometimes myxedema. In the United States, the most common cause of hypothyroidism is hashimoto's thyroiditis, an autoimmune disorder.[icd10data.com]
Apathy
  • The patient at diagnosis with apathy, myxedema of the extremities, and sparse-brittle hair. Bone age was severely delayed (6 years as assessed by the Greulich and Pyle standard).[hormones.gr]
  • Symptoms suggestive of hypothyroidism such as weight gain, growth failure, lassitude, mental apathy, hoarseness, puffiness of eyes, hair loss, poor appetite and constipation were noted in 54% with varying clinical signs of hypothyroidism.[indianpediatrics.net]
Delayed Menarche
  • […] status (V49.81) 256.3 Other ovarian failure Use additional code for states associated with natural menopause (627.2) Excludes: asymptomatic age-related (natural) postmenopausal status (V49.81) 256.31 Premature menopause 256.39 Other ovarian failure Delayed[theodora.com]

Workup

Delayed Bone Age
  • When thyroid hormone is absent from birth, it leads to growth arrest, delayed bone age, and short stature.[thetrp.net]
  • Children with poor linear growth, delayed bone age, and abnormal GH stimulation tests are considered GH deficient.[nursekey.com]
  • In those presenting with marked growth failure, delayed bone age and other features of hypothyroidism, the thyroid gland is often not palpable due to the aggressive fibrous variant of AITD(2,23).[indianpediatrics.net]
Enlarged Sella
  • X-ray skull sellar view [Figure 1] showed an enlarged sella with hypoplastic maxillary and frontal sinuses.[thetrp.net]
Abnormal Thyroid Function Test
  • THYROID FUNCTION TEST 47 THYROID DISORDERS OF INFANCY 462 P A RT IV CALCIUM AND BONE METABOLISM 473 MORPHOLOGY OF THE PARATHYROID 51 PARATHYROID HORMONE 497 PHYSIOLOGY OF CALCIUM 52 PARATHYROID HORMONERELATED 512 CLINICAL APPLICATION OF BONE MINERAL[books.google.com]

Treatment

  • Alternative treatment Alternative treatments are primarily aimed at strengthening the thyroid and will not eliminate the need for thyroid hormone medications.[medical-dictionary.thefreedictionary.com]
  • […] photographs of normal and abnormal skin conditions including images of rare conditions, this easily accessible resource is essential for pediatricians, neonatologists, and dermatologists as well as other healthcare professionals involved in the diagnosis and treatment[books.google.de]
  • Primary - Hashimotos thyroiditis Iatrogenic-Hyperthyroid treatment Drugs: iodine excess, contrast, hyperthyroid treatment Congenital hypothyroidism Hypopituitarism: Hypothalamic disorders Associated autoimmune diseases of hypothyroidism Rheumatoid arthritis[quizlet.com]
  • Treatment and prognosis of Grave’s disease in children and adolescents. UpToDate, Inc. 2014 Jan 10. Available at: Accessed on: November 8, 2015.[rarediseases.org]
  • Exposure to high doses of radiation for the treatment of head and neck cancers. Radioactive iodine ( RAI ) treatment for Grave's disease may cause hypothyroidism. Dyshormonogenesis is a autosomal recessive disease caused by peroxidase deficiency.[flexikon.doccheck.com]

Prognosis

  • Treatment and prognosis of Grave’s disease in children and adolescents. UpToDate, Inc. 2014 Jan 10. Available at: Accessed on: November 8, 2015.[rarediseases.org]
  • Childhood bullous pemphigoid: clinical and immunologic features, treatment and prognosis. Arch Dermatol 1991;127:378-86. 2. Borradori L, Bernard P. Pemphigoid group. In: Bolognia JL, Jorizzo JL, Rapini RP. Dermatology.[degruyter.com]
  • Prognosis Thyroid hormone replacement therapy generally maintains normal thyroid hormone levels unless treatment is interrupted or discontinued.[medical-dictionary.thefreedictionary.com]
  • If not, the prognosis remains dismal. [5] History [ edit ] Myxedema was first treated successfully in 1891, when George Redmayne Murray diagnosed a 46-year-old woman with the disease. He prescribed an extract from sheep thyroid.[en.wikipedia.org]
  • Prognosis If CH is detected early in infants and treatment begun, normal development of mental function can occur. [ 11 ] If treatment is delayed, spasticity, gait problems and dysarthria and profound mental disability may result.[patient.info]

Etiology

  • In 183 short chapters, the book provides the essentials clinicians need on symptoms/signs, diagnostic tests, and neurologic disorders of all etiologies. For this edition, Timothy A.[books.google.de]
  • Etiology May be congenital (e.g., atresia, duplication), acquired (e.g., neoplastic, inflammatory), or iatrogenic (e.g., adhesions, radiation stricture) Etiology varies by age: Neonates Intestinal atresia (most common cause in neonates) Obstructive meconium[unboundmedicine.com]
  • Etiology:   Autoimmune Infection Drugs 44.[slideshare.net]
  • Hypothyroidism key point: inadequate amount thyroid hormones triiodothyronine (T3) and thyroxine (T4) result in decrease in metabolic rate most common etiology - Disease or thyroid gland loss.[quizlet.com]
  • Rare in the US Remains the most common cause of hypothyroidism worldwide Hypothyroidism In areas of iodine sufficiency Autoimmune disease (Hashimoto's thyroiditis) Iatrogenic causes (treatment of hyperthyroidism) are most common Etiology of hypothyroidism[quizlet.com]

Epidemiology

  • Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocr Rev. 2008;29:697-725. Jacobson EM, Tomer Y.[rarediseases.org]
  • Bullous pemphigoid in infancy: Clinical and epidemiologic characteristics. J Am Acad Dermatol 2008;58(1):41-8. 4. Fisler RE, Saeb M, Liang MG, Howard RM, McKee PH. Childhood bullous pemphigoid: a clinicopathologic study and review of the literature.[degruyter.com]
  • Epidemiology In the UK, 1 in 4,000 live births have CH. The incidence is twice as common in girls. [ 1 ] Areas with iodine deficiency associated with endemic CH are Bangladesh, China, Peru and Zaire.[patient.info]
  • Inoue M, Taketani N, Sato T, Nakajima H (1975) High incidence of chronic lymphocytic thyroiditis in apparently healthy school children: epidemiological and clinical study. Endocrinol Jpn 22:483–489 Google Scholar 11.[link.springer.com]
  • Statistics and Epidemiology Hypothyroidism occurs in specific individuals at different instances. Hypothyroidism occurs most frequently in older women .[nurseslabs.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Pathophysiology depends on the mechanism of the obstruction.[unboundmedicine.com]
  • Pathophysiology The parietal cells are present in the proximal portion of gastric mucosa and produce acid ( HCL ) and Intrinsic factor. Intrinsic factor is needed for the absorption of vit B 12.[labpedia.net]
  • Pretibial myxedema can occur in 1–4% of patients with Graves' disease , a cause of hyperthyroidism. [3] Hypothyroidism , including Hashimoto's thyroiditis. [ citation needed ] Pathophysiology [ edit ] Myxedema describes a specific form of cutaneous and[en.wikipedia.org]
  • Pathophysiology Hypothyroidism is among the most common endocrine diseases.[reference.medscape.com]

Prevention

  • A durable cover with round edges helps prevent the book from being damaged and makes it easier to handle.[books.google.com]
  • Prevention Primary hypothyroidism can't be prevented, but routine screening of adults could detect the disease in its early stages and prevent complications. Key terms Cretinism — Severe hypothyroidism that is present at birth.[medical-dictionary.thefreedictionary.com]
  • Intervention - respiratory: encourage cough and deep breathing, prevent complications. Nur. intervention - diet: high bulk, low-calorie. Exercise to prevent constipation and promote weight loss. Laxatives and softeners PRN. Nur.[quizlet.com]
  • Prevention Prevention of hypothyroidism can be achieved with the following: Increase in iodine intake. Iodine intake is the foremost prevention strategy in hypothyroidism. Early detection.[nurseslabs.com]
  • […] respiratory failure Intravenous levothyroxine Parenteral hydrocortisone - prevents adrenal crisis[quizlet.com]

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