Page 185 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-017
Neonatal Screening for Congenital Hypothyroidism in Malang, East Java 2020

Irfan Agus Salim, Berlian Ristina Putri, Tiara Afia Rosmalawati, , Haryudi Aji Cahyono, Fadhilah Muttaqin
Departement of Child Health , Faculty of Medicine Universitas Brawijaya/Saiful Anwar General Hospital,
Malang, East Java, Indonesia
Abstract
Background Congenital hypothyroidism is defined as thyroid hormone deficiency present at birth. Congenital
hypothyroidism must be diagnosed immediately because delaying in therapy can cause irreversible
neurological deficits, namely mental retardation in children. However, this situation can be obtained by
doing newborn screening which leads to earlier diagnosis and therapy. Thus, resulting in better neurological
development. Objective To determine the ratio of congenital hypothyroidism in Malang from March to
November 2020. Methods This study is using descriptive analysis method. The subjects of this study were
neonates aged 0-28 days with a gestational age of 36 weeks involving Public Health Service in Malang.
Identity, gender, age at screening, and gestational age were collected. Laboratory tests are performed
by taking a blood sample from the heel or vein for a TSH test. If the result is positive with a TSH value
> 20 µU/mL, then the patient will be recalled for a confirmatory test and refer to a pediatric endocrinologist.
Results From 2291 subjects, there were 2024 (88.34%) subjects who were successfully screened. The recall
rate for congenital hypothyroidism was 1:2024 (0.04%). Conclusion Congenital hipothyroidism ratio in
Malang from March to November 2020 is higher than global ratio, 1:3000. The high rate of congenital
hypothyroidism in Malang indicates the need for congenital hypothyroidism screening in neonates.
Keywords: neonatal screening for congenital hypotiroidism; Malang East Java 2020

P-ENDO-018
Diabetic Ketoacidosis Triggered by Mucormycosis Infection
in Children with Newly Diagnosed Type 1 Diabetes: A Case Report

Aldila Pratiwi, Muhammad Faizi, Nur Rochmah
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Hospital,
Surabaya, East Java, Indonesia

Abstract
Background Mucormycosis has emerged as a rare but frequently fatal invasive fungal disease. It is an
important cause of death in young patients with diabetes mellitus who have poor glycemic control and acute
ketosis. The incidence of mucormycosis is approximately 1,7 cases per 1.000.000 inhabitants per year. Overall
mortality is 56% in children. Objective To provide an overview and management of mucormycosis infection
in children with diabetic ketoacidosis. Case A 9 years old girl was referred to emergency department of our
hospital with diagnosing diabetic ketoacidosis. She came with chief complaint of dyspnea since 2 days and
decrease of consciousness since 1 day before admission. She had a history of sore throat with oral sprue
and black palatal eschar. She got polyuria and polydipsia. There was no history of diabetes mellitus. The
laboratory result at admission found high blood glucose, high keton level and severe metabolic acidosis.
The head MRI examination revealed cerebral abscess and pansinusitis. Craniotomy and debridement were
done. Cytological smear was taken from palatal region and Grocott-Gomori methenamine silver (GMS)
stain revealed aseptate hyphae showing branching at 90°. The diagnosis of rhinocerebral mucormycosis was
confirmed by the clinical, radiological and histopathological findings. She treated with liposomal amphotericin
B followed by oral Fluconazole. After 2 months, the clinical symptoms already improved and she allowed
to discharged. Conclusion Diabetic ketoacidosis triggerred by mucormycosis infection in our hospital was
relatively rare. Early identification and treatment will resolve the prognosis.
Keywords: diabetic ketoacidosis; mucormycosis; type 1 diabetes mellitus

KONIKA XVIII Abstract Book 137