Hubungan Awitan Pengobatan Hipotiroid Kongenital dengan Gangguan Perkembangan Anak di Rumah Sakit Umum Pusat Dr. Hasan Sadikin

Adhitya Agung Pratama, Alex Chairulfatah, Novina Novina, Faisal Faisal, Eddy Fadlyana

Sari


Latar belakang. Hipotiroid kongenital (HK) adalah kondisi kekurangan hormon tiroid, tiroksin, dan tri-iodotironina sejak lahir yang dapat menyebabkan gangguan organogenesis sistem saraf pusat serta metabolisme tubuh. Penderita HK yang tidak diterapi dapat berlanjut menjadi individu dengan gangguan perkembangan. Data di Indonesia dari Ikatan Dokter Anak Indonesia (IDAI) sejak tahun 2000-2013, angka kejadian HK pada bayi baru lahir sebanyak 1:2736.
Tujuan. Mengetahui hubungan awitan pengobatan dengan gangguan perkembangan pada anak dengan HK.
Metode. Penelitian observasional analitik dengan pendekatan potong lintang yang dilakukan periode bulan Agustus–November 2018. Subjek HK datang kontrol ke klinik rawat jalan endokrin dan tumbuh kembang RS. Hasan Sadikin, berusia <36 bulan dan mendapat terapi levotiroksin, dilakukan penilaian perkembangan dengan pemeriksaan Denver dan CAT/ CLAMS (cognitive adaptive test/ clinical linguistic auditory milestone scale). Analisis data menggunakan uji chi-kuadrat dan Mann Whitney (p<0,05).
Hasil. Terdapat 92 kasus HK, 12 dieksklusi, subjek terdiri dari 38 laki-laki dan 42 perempuan dengan rerata usia diagnosis 3,0 bulan (0,5–22,0 bulan). Didapatkan adanya hubungan usia saat diagnosis dan awitan pengobatan dengan gangguan perkembangan (p<0,001). Usia saat diagnosis dan awitan pengobatan >3 bulan lebih banyak mengalami gangguan perkembangannya.
Kesimpulan. Pasien HK yang terlambat didiagnosis dan diberikan terapi akan mengalami gangguan perkembangan yang lebih banyak.

 


Kata Kunci


CAT/CLAMS; Denver; Gangguan perkembangan; Hipotiroid kongenital

Teks Lengkap:

PDF

Referensi


Depkes. Situasi dan Analisis Penyakit Tiroid. In: Indonesia DKR, penyunting. Jakarta: Depkes; 2015.

Bona G, Bellone S, Prodam F, Monzani A. Etiology of Congenital Hypothyroidism. Thyroid Diseases in Childhood. Switzerland: Springer; 2015.h. 27-31.

Seo MK, Yoon JS, So CH, Lee HS, Hwang JS. Intellectual development in preschool children with early treated congenital hypothyroidism. Ann Pediatr Endocrinol Metab 2017;22:102-7.

Frezzato RC, Santos DCC, Goto MMF, Ouro MPCd, Santos CTMd, Dutra V, dkk., editors. Fine motor skills and expressive language: a study with children with congenital hypotyreoidism. CoDAS; 2017: SciELO Brasil.

Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Role of thyroid hormone during early brain development. Eur J endocrinol 2004;151 Suppl 3:U25-37.

Therrell BL, David-Padilla C. Screening of Newborns for Congenital Hypothyroidism: Guidance for Developing Programmes: IAEA; 2005.

Dalili S, Rezvani SM, Dalili H, Amiri ZM, Mohammadi H, Kesh SA, dkk. Congenital hypothyroidism: etiology and growth-development outcome. Acta Med Iran 2014;52:752.

Desai MP. Congenital hypothyroidism: Screening dilemma. Indian J Endocrinol Metab 2012;16 Suppl 2:S153.

Campos MLP, Musso M, Keselman A, Gruneiro L, Bergadá I, Chiesa A. Cognitive profiles of patients with early detected and treated congenital hypothyroidism. Arch Argent Pediatr 2017;115:12-7.

Heidari Z, Feizi A, Hashemipour M, Kelishadi R, Amini M. Growth development in children with congenital hypothyroidism: the effect of screening and treatment variables—a comprehensive longitudinal study. Endocrine 2016;54:448-59.

Van der Sluijs Veer L, Kempers MJ, Wiedijk BM, Last BF, Grootenhuis MA, Vulsma T. Evaluation of cognitive and motor development in toddlers with congenital hypothyroidism diagnosed by neonatal screening. J Dev Behav Pediatr 2012;33:633-40.

Smith L. Updated AAP guidelines on newborn screening and therapy for congenital hypothyroidism. Amer acad Family Physicians; 2007.

Najmi SB, Hashemipour M, Maracy MR, Hovsepian S, Ghasemi M. Intelligence quotient in children with congenital hypothyroidism: The effect of diagnostic and treatment variables. J Res Med Sci 2013 ;18:395-9.

Kooistra L, Laane C, Vulsma T, Schellekens JM, van der Meere JJ, Kalverboer AF. Motor and cognitive development in children with congenital hypothyroidism: a long-term evaluation of the effects of neonatal treatment. J Pediatr Pediatr Med 1994;124:903-9.

Buluş AD, Tiftik E. Evaluation of neurodevelopment of children

with congenital hypothyroidism by the Denver Developmental Screening Test. J Pediatr Endocrinol Metab 2017;30:1061-6.

LaFranchi SH, Austin J. How should we be treating children with congenital hypothyroidism? J Pediatr Endocrinol Metab 2007;20:559-78.

Rustama D, Fadil MR, Harahap ER, Primadi A. Newborn screening in Indonesia. Southeast Asian J Trop Med Public Health 2004;34:76-9.

Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. The Denver II: a major revision and restandardization of the Denver Developmental Screening Test. BMJ Paediatr Open 1992;89:91-7.

Accardo PJ, Capute AJ. The Capute Scales: Cognitive Adaptive

Test/Clinical Linguistic & Auditory Milestone Scale (CAT/CLAMS). Illionis: Brookes Pub; 2005.

Büyükgebiz A. Newborn screening for congenital hypothyroidism. J Pediatr Endocrinol Metab 2006;19:1291-8.

Nakamizo M, Toyabe S-i, Asami T, Akazawa K. Mental development of infants with congenital hypothyroidism: a longitudinal study. Clin Pediatr 2007;46:53-8.

Scharf RJ, Stroustrup A, Conaway MR, DeBoer MD. Growth and development in children born very low birthweight. Arch Dis Child Fetal Neonatal Ed 2016;101:F433-8.

Bongers-Schokking JJ, Koot HM, Wiersma D, Verkerk PH, de Muinck Keizer-Schrama SM. Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism. J Pediatr 2000;136:292-7.

Wirawan A, Sunartini S, Suryawan B, Soetjiningsih S. Tumbuh Kembang Anak Hipotiroid Kongenital yang Diterapi dini dengan Levo-tiroksin dan Dosis Awal Tinggi. Sari Pediatri 2016;15:69-74.

25. Claret C CJ, Goday A. Hypothyroidism and Down’s syndrome. Rev Med Int Sindr Down 2013;17:18-24.

Pop VJ, Kuijpens JL, van Baar AL, Verkerk G, van Son MM, de Vijlder JJ, dkk. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clin Endocrinol 1999;50:149-55.

Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, dkk. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. BMJ Paediatr Open 1999;341:549-55.

Anastácio-Pessan FdL, CusinLamônica DA. Congenital hypothyroidism: influence for language and behavioral skills: study review. Revista CEFAC 2014;16:1990-6.




DOI: http://dx.doi.org/10.14238/sp21.1.2019.16-23

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.