cretinism
definition
Cretinism refers to the congenital hypothyroidism or underactivity of thyroid glands during early childhood leading to stunted growth and mental retardation
causes
Lack of thyroid gland and failure of the thyroid gland to produce thyroid hormone
pathophysiology
Iodine deficiency in the diet
An optimal level of maternal thyroid status is essential for the normal growth of the fetus
is essential for growth, branching and myelination of neuronal cells of CNS at fetal and neonatal stage
Thyroid hormone also plays a critical role in skeletal muscle development than soft tissue development.
clinical manifestation
Short stature (dwarfism)
Unable to maintain posture and balance with characteristic walking style
Enlargement of the thyroid gland (goiter).
Hearing and speech defect
diagnosis
Technetium
Radioactive Iodine (RAIU) test
Blood spot test such as Guthrie’s test
antenatal screening test in the first month of life.
treatment
Everyday treatment with thyroxine should be initiated as early as possible as mental retardation that has ensued already is only partially reversible
management
asses vital sings
change patient position
use of low pressure mattress
cardiac assessment
observe input and output
administer thyroid hormone