[Frequency of overtreatment and undertreatment in children with congenital hypothyroidism in Qom Province, Iran]

ABSTRACT

Congenital hypothyroidism [CH] is one of the most important preventable causes of mental retardation in the world. In the recent years, overtreatment and under treatment episodes are considered as one of the most important causes of neurocognitive developmental disorders in patients with CH, which have been taken into consideration in recent years. The current study aimed to evaluate the frequency of overtreatment, undertreatment and dose of respective drug in these in patient with CH in Qom city. In a study performed according to the existing data [Routine Data Base Study] in Mirei Clinic of Qom city, 201 medical records and 823 thyroid function tests were extracted from 2006 to 2011. The data were analyzed using independent t- and chi-square tests. The significance level was considered p < 0.05. Of 201 patients whose records were complete, respectively, 173 patients [86.07%] and 69 patients [34.3%] had at least one episode of overtreatment and undertreatment. In 151 [87.2%] and 30 [43%] patients, respectively, at least one episode of overtreatment and one episode of undertreatment were reported before 6 months of age. The mean weight and primary T4 in undertreatment patients were significantly higher. There was no significant difference between two sexes in the two groups of overtreatment and undertreatment. 449 [83%] out of 538 overtreatment episodes were in patients who took the treatment dose lower than recommended dose. According to the results of this study, the prevalence of overtreatment and undertreatment in first 6 month of treatment was more common. The highest incidence of overtreatment occurred with lower than recommended dose. Also, the weight and primary T4 can be a guide for adjustment of drug doses in patients with CH