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