Congenital Hypothyroidism with Atrial Septal Defect Accompanied and Severe Anemia in A 15-Month-Old Infant:A Case Report from A Resource Limitec Tanzanian Setting

Congenital hypothyroidism (CH) is a condition characterized by the thyroid gland's inability to synthesize sufficient quantities of thyroid hormones in neonates. These hormones are indispensable for normal cerebral development, growth, and metabolic functions in infants. Often, it constitutes a permanent condition that necessitates lifelong management. The incidence of congenital hypothyroidism is estimated to be approximately 1 in 2,000 to 4,000 live births. This condition can be classified based on its etiology into "Primary" or "Secondary" hypothyroidism, the latter also referred to as "Central" hypothyroidism, or based on its duration into "Transient," indicating potential improvement over time, or "Permanent" hypothyroidism. The predominant congenital form of hypothyroidism is primary hypothyroidism, primarily resulting from thyroid dysgenesis, which accounts for approximately 80% of cases. Notably, the majority of infants diagnosed with CH are typically asymptomatic at birth. This paper elucidates a case of congenital hypothyroidism (CH) in a 15-month-old toddler who presented at our pediatric ward exhibiting failure to thrive, chronic constipation, delayed developmental milestones, and multiple congenital anomalies, including congenital heart disease and umbilical hernia. These manifestations arose from the protracted challenges in diagnosis attributable to the absence of policies for newborn screening and maternal thyroid hormone assessment during antenatal care (ANC) in many developing nations, with Tanzania being a notable example The significance of this case report is to create awareness on presence of rare associated anomalies and to identify gaps in health care accessand also to sdhow the long-term outcomes of delayed vs timely intervention.