Cretinism

Definition

Definition of Cretinism
Cretinism is a condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones (congenital hypothyroidism) usually due to maternal hypothyroidism.

Symptoms

Symptoms of Cretinism
Symptoms include execute growth, twined facial features, increased tongue and mental detainment. The typical:

1. floppy infant
2. thick, protruding tongue
3. poor feeding
4. choking episodes
5. constipation
6. prolonged jaundice
7. short stature

Causes

Causes of Cretinism

1. Maternal deficiency of iodine in the diet.
2. An absent or poorly developed thyroid gland.
3. A pituitary gland that fails to stimulate the thyroid gland.
4. Poorly formed or non-functioning thyroid hormones (thyroid hormone receptor abnormalities).
5. Hashimoto’s thyroiditis (chronic autoimmune inflammation of the thyroid gland), where the body’s immune system is affected.
6. Post-surgical complications of thyroid gland done to treat overactive thyroid gland.
7. Radioactive iodine treatment done in pregnancy for an overactive thyroid gland.
8. The inability of the body to convert iodine to active form- iodine in conditions like Pendred syndrome, Thyroglbulin defect and deiodinase defect.
9. Genetic problems like familial or inherited autosomal recessive condition wherein there is an impaired iodine uptake or unresponsive Thyroid-stimulating hormone or TSH.
10. Usage of medicines like lithium, amiodarone (Cordarone X tablets) and propylthiouracil, carbimazole (Neo-mercazole).
11. Consumption of excessive iodine in the cough syrup. This can cause hypothyroism only if a radioactive treatment was done previously.
12. Transplacental passage of antibodies.

Diagnosis

Diagnosis of Cretinism
Advance diagnosis, and life long cure with thyroid hormone by mouth, afford the child a better adventure of evolving usually. Newborns analysed and treated in the first month to month and a half typically produce general intelligence.

Treatment

Treatment of Cretinism
Medication

1. Levothyroxine (Levothroid, Levoxyl, Synthroid) is the preferred thyroid hormone replacement. This is because it has been proven to be safe, not expensive, effective, and can be monitored and administered easily. It is not advisable to buy the suspension form of medicine from pharmacy, as  the drug can lose its effectiveness.
2. Parents should be taught on how to properly administer the drugs. The pill or tablet should not be mixed in a whole bottle of milk or other substance. Instead, it should be crushed and to be dissolved with a small amount of water or breast milk, and should be given via droppers or a syringe without the needle.
3. The physician, usually, decides  the dose, but mostly an initial dose of 10-15 mcg/kg/dl is recommended. With that, there have been positive feedback, wherein the thyroid-stimulating hormone levels have considerably increased.

Diet
Generally, foods which are rich in iodine are given, so that complications do not occur. Thus, the dietary iodine deficiency is the most common preventable solution worldwide. Foods with soy-based formulas, even though decreases the absorption of levothyroxine, it is stil recommended, as it maintains the thyroid hormone at a normal range.

Activity
Activity should be persuaded to children to make them feel not left out. After all, activity is encouraged to many children. However, with severe cases of crenitism, assisting in the activities of daily living should be done to ensure the safety of the child.

Prognosis

Prognosis of Cretinism
Good prognosis can be seen if congenital hypothyroidism is diagnosed before 13 postnatal days (after birth), and normalization of thyroid hormone blood levels by third postnatal week.

Prevention

Prevention of Cretinism
Consult with your doctor.