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Thyroid Gland Disorders...

The thyroid gland is located in the front of the neck. It produces thyroid hormone, which controls the speed at which the body's chemical functions proceed (metabolic rate).

Some problems that affect the thyroid gland may also cause the gland to enlarge--a condition called goiter. A goiter may exist if the thyroid gland is underactive (producing too little thyroid hormone) or overactive (producing too much). An enlarged thyroid gland that is present at birth is called congenital goiter. Some children have Pendred's syndrome, a hereditary condition that combines deaf-mutism and congenital goiter.

Hypothyroidism results when the thyroid gland cannot produce adequate amounts of thyroid hormone for the body's needs. Symptoms of hypothyroidism in children and adolescents differ from those in adults. In newborns, hypothyroidism causes cretinism (neonatal hypothyroidism), which is characterized by jaundice, poor appetite, constipation, a hoarse cry, outpouching of the navel (umbilical hernia), and slowed bone growth. If not diagnosed and treated within a few months of birth, hypothyroidism results in mental retardation. Hypothyroidism that begins in childhood (juvenile hypothyroidism) slows growth, sometimes resulting in disproportionately short limbs. Tooth development is delayed.

Hypothyroidism that begins in adolescence (adolescent hypothyroidism) is similar to that in adults, except that it may delay puberty. Symptoms include a hoarse voice, slowed speech, droopy eyelids, a puffy face, hair loss, dry skin, a slow pulse, and weight gain.

In all newborns, the thyroid hormone level in the blood is routinely measured within 2 days of birth. A newborn who has hypothyroidism is promptly given thyroid hormone as replacement. This treatment prevents brain damage. Hypothyroidism that begins in childhood or adolescence is also treated with a replacement hormone.

Hyperthyroidism results from overactivity of the thyroid gland. In newborns, the most common cause of hyperthyroidism is neonatal Graves' disease, a potentially life-threatening illness that can occur in infants whose mothers have or have had Graves' disease. Graves' disease, a form of hyperthyroidism, is an autoimmune disorder in which the body produces antibodies that stimulate the thyroid gland. In pregnant women, these antibodies cross the placenta and stimulate the fetus' thyroid gland. Graves' disease in the mother may result in stillbirth, miscarriage, or premature birth. In a newborn, symptoms of an overactive thyroid gland--poor weight gain, fast heart rate, high blood pressure, nervousness or irritability, vomiting, and diarrhea--may start within several days after birth. The enlarged thyroid gland (goiter) can press on the windpipe and interfere with breathing. The high thyroid hormone levels cause the fast heart rate, which can lead to heart failure. Bulging eyes, common in the adult form of the disorder, also occur in newborns. Graves' disease is potentially fatal if not recognized and treated appropriately.

Infants who receive treatment recover within weeks, although they may remain at risk of recurring illness for 6 months to a year. Persistently high levels of the thyroid-stimulating antibodies can also lead to premature closure of the bones of the skull (fontanelles), mental retardation, hyperactivity later in childhood, and slowed growth.

Hyperthyroidism is treated with a drug, such as propylthiouracil, that blocks the formation of thyroid hormones. Infants may also need treatment for heart failure. For severely affected newborns who have very high blood levels of thyroid-stimulating antibodies, an exchange blood transfusion (in which some of the newborn's blood is removed and exchanged with donated blood) may be needed to decrease the antibody levels.

** Thyroid Symptoms Artist, John Karapelou from

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