types of cretinism

Cretinism is a congenital form of deficiency of thyroid hormones, retarding mental and physical growth. In the landmark trial of 165 000 people living in an area of Papua New Guinea with severe iodine deficiency and endemic cretinism (Pharoah et al., 1971), families were allocated to iodine (iodised oil) or placebo (saline) and subsequent follow-up studies of the original cohort found that an injection of iodised oil before conception or in early pregnancy reduced the incidence of cretinism and improved the motor and cognitive functions of children compared with placebo treatment. This view implies that anyone who is iodine deficient may be at risk of sub-optimal cognitive and psychomotor function. A cretin is a person affected by cretinism. S.A. Skeaff, in Lifetime Nutritional Influences on Cognition, Behaviour and Psychiatric Illness, 2011. Cretinism Important features include: unusual facial features (broad, flat nose, widely set eyes) tongue which is out of proportion to the mouth (i.e. Maria-Jesus Obregon, ... Gabriella Morreale de Escobar, in Comprehensive Handbook of Iodine, 2009. Severe hypothyroidism in infants can result in cretinism. Further corroboration of the hypothesis came from epidemiological studies in northern Congo (Goyens et al., 1987; Vanderpas et al., 1990) and from an experimental study in rats showing that selenium deficiency increased the toxic effects of other agents in iodine-deficient rats (Contempre et al., 1993). This medical condition affects the humans differently according to the age it is being affected. Some countries and regions have a higher prevalence of one type of cretinism than the other, and sometimes the symptoms of both types of cretinism can manifest in the same individual. These defects point to early damage of specific brain structures (Cao et al., 1994) and, e.g., in the case of deafness, to damage in the cochlear development that occurs in the first trimester of pregnancy. Iodine deficiency has been recognized as the most frequent cause, after starvation, of preventable mental defects, affecting hundreds of million people to different degrees. Table 64.2. This list has increased during the last years considering situations, such as prematurity, where deprivation of maternal thyroid hormones during the last part of gestation has negative effects on the neurological development of the baby. Lack of thyroid gland and failure of the thyroid gland to produce thyroid hormone (congenital cretinism or congenital iodine deficiency syndrome). Hetzel, in International Encyclopedia of Public Health, 2008. About one billion people worldwide risk the consequences of iodine deficiency, all of which can be prevented by adequate maternal and infant iodine nutrition. © Massachusetts Medical Society. This type of hypothyroidism is also called congenital hypothyroidism, non-goitrous (CHNG). For more information, we refer to several reviews on the effects of iodine deficiency on brain development (DeLong, 1989; Morreale de Escobar et al., 1989, 1997, 2004; Morreale de Escobar and Escobar del Rey, 2003; Obregon et al., 2005). Cretinism is of 2 types: Congenital Cretinism. The word cretin is derived from the French word  chrétien, literally meaning “Christian” or “Christ like” as the diseased were mentally retarded and incapable of doing sin. Types of Cretinism: Neurological Cretinism It affects the nervous syste and caused by lack of thyroid hormones from the mother during third to sixth month of pregnancy, the severe lack of iodine means the fetus is unable to produce thyroid hormones during this period, which is very dangerous as during this period the brain is developing the ability to hear and perform other motor functions . A hypothyroid cretin from Sinjiang, China, who is also deaf mute. Reproduced from Hetzel (1989). Figure 62.2. This type of cretinism has been eradicated, due to early diagnosis of this condition. M.B. Goitre and cretinism provided the visual picture of iodine deficiency that gave it an easily identifiable reference. The lack of goitrogens in Tibet probably explains the lower frequency of hypothyroidism and goiter despite similar urinary iodine concentrations to those in Central Africa. Further, the nature of the neurological deficit associated with both types of endemic cretinism has received scant attention in recent times considering that it remains a common disorder in many parts of the world. This form is regarded as a major public health problem in many countries [3]. Cretinism, also known as congenital hypothyroidism, is a condition caused by a deficiency of thyroid hormones while a fetus is developing in the womb or shortly after birth. Venkatesh Mannar, in Food Fortification in a Globalized World, 2018. Because selenium deficiency impairs the conversion of T4 to T3 in the periphery, preserving maternal levels of circulating T4, this mechanism was proposed to supply the necessary T3 to the fetal brain during the critical period when the maturation of the nervous system depends mainly on maternal T4. Distribution of urinary iodine concentrations in 557 subjects from 12 villages in Lhasa Prefecture, Tibet. This term has come to be regarded as insulting in the general population, although it is appropriate within technical settings. Nonetheless, the lack of iodine in the diets of pregnant women in the first trimester appears to be a common factor in both forms of cretinism, suggesting that maternal hypothyroidism is responsible for irreversible damage to the foetal brain. This mainly due to the defect in the genes which is responsible for encoding the various enzymes involved in the thyroid hormone synthesis such as thyroglobulin, iodotyrosine deiodinase and also thyroid-stimulating hormone. The collective term for the multiple adverse effects on growth and development in animals and humans caused by iodine deficiency and the resulting inadequate thyroid hormone production. Hypothyroidism is not frequent in neurological cretins and goiter is common. The dose should be increased as the age progresses. Pro Lite, Vedantu Cretinism is a medical condition present at birth wherein there is a decreased or absent thyroid function and thyroid hormone production [1]. They include cranial abnormalities, cretinism, phenylketonuria (), Down syndrome, and nonsydromic mental retardation.All types of mental retardation typically cause mental delays measured by intelligence quotient tests. Studies done in Papua New Guinea (Choufoer et al., 1965) suggested that the birth of cretins was ­causally related to incapacity to increase plasma T4 (as measured by PBI) during pregnancy, even if the women were not hypothyroid. Distribution of serum selenium concentrations in 521 subjects from 12 villages in Lhasa Prefecture. Cretinism is a congenital disorder meaning it is present at birth. Experimental studies showed that selenium deficiency in rats decreases D1 and increases serum T4 (Arthur et al., 1988; Beckett et al., 1987). This disorder is sometimes caused during fetal development, when the thyroid is underdeveloped, but can also be caused in adulthood from injury to the thyroid gland. These observations raised doubts regarding whether iodine deficiency was a significant causative factor in cretinism (Lancet, 1972). The estimated effect of various degrees of iodine deficiency on IQ score. This mainly due to the defect in the genes which is responsible for encoding the various enzymes involved in the thyroid hormone synthesis such as thyroglobulin, iodotyrosine deiodinase and also thyroid-stimulating hormone. It is present from birth. Treatment should be started before the onset of symptoms, if developmental abnormalities and mental retardation starts to appear, will not reverse even on thyroid hormone replacement therapy. Neurological cretinism is characterized by mental retardation, deaf mutism, … Cretinism is classified into the following two types: Endemic cretinism. Iodization of table salt and early screening of babies has largely eliminated the condition from such regions. As IDD elimination progressed, these physical manifestations became far and fewer giving the impression that IDD problem had been solved. He is severely mentally impaired, deaf-mute and suffered from spastic diplegia, but without clinical signs of Kashin–Beck disease. Iodine from iodine-based topical antiseptic can be absorbed and lead to toxicity when applied to broken down skin barrier in large are as seen in burn victims. Figure 71.4. (1987) hypothesized that the thyroid atrophy of myxedematous cretins could result from the toxic effect of increased H2O2 generation by the thyrocytes due to chronic TSH stimulation induced by iodine deficiency. These long-lasting injections were shown to correct iodine deficiency and prevent goiter for 3 to 5 years depending on the dosage. Transportation of iodine in anionic form into the follicular cell takes place with the help of active transport and it moves into the follicular lumen by facilitated diffusion. Myxedematous and neurological cretinism are the most severe consequences of iodine deficiency. Cretinism could not be prevented unless the iodized oil was given before pregnancy, as injection during pregnancy was ineffective (Table 62.2). Six already pregnant when injected with oil. A study of 112 cretins (neurological, myx-oedematous, and mixed) living in Thailand reported that their mean IQ score was 30.8 ± 8.8 (Rajatanavin et al., 1997). It is diagnosed by newborn screening schemes along with the lifelong treatment of thyroxin. The combination of the controlled human trials with the results of the studies in animal models clearly indicated that prevention was possible by correction of the iodine deficiency before pregnancy. Recommended dose is 10 to 15ug per kg body weight. Iodine deficiency in diet (Endemic cretinism). To convert values for urinary iodine to nanomoles per liter, multiply by 78.7. Sornwichate Rattanachaiwong, Pierre Singer, in Encyclopedia of Food Security and Sustainability, 2019. Cretinism is a condition of severe physical and mental retardation due to iodine deficiency, and specifically due to deficiency of thyroid hormones during early pregnancy. The maternal thyroid hormone is the only source for the fetus that crosses the placenta for fetal brain development. Replacement of the hormone will produce an immediate effect. There are two main types of cretinism 9). Fourteen percent had urinary iodine concentrations <0.6 μg/dl, 66% had concentrations <2 μg/dl, and 95% had concentrations <5 μg/dl. Thyroid hormone plays a major role in the growth, branching and myelination of neuronal cells of CNS at fetal and neonatal stage. Thereafter, several groups in New Guinea, Peru and China presented evidence that hypothyroxinemia of pregnant women was the cause of the birth of neurological cretins, as well as of the reproductive failure of women (Fierro-Benitez et al., 1970; Pharoah et al., 1971; Pretell et al., 1974; Zhu et al., 1981; Hou et al., 1982). Cretinism. At the border of follicular cells oxidation of iodide into iodine takes place. In the first 12 weeks of gestation the fetus is dependent on maternal thyroid hormone. Experimentally, the involvement of thiocyanate in the pathogenesis of myxedematous cretinism has recently been corroborated (Contempre et al., 2004). Iodine is an essential trace element; it is necessary and required for the synthesis of thyroid hormones. The latter mechanism is considered as an escape phenomenon from Wolff-Chaikoff effect. The numbers on the horizontal axis represent the midpoint of the intervals shown. Dr Adil Ramzan. It can result from the lack of a thyroid gland or from iodine-131 treatment, and can also be associated with increased stress. of progeny, Early correction of maternal hypothyroxinemia, Combined maternal and fetal hypothyroidism: severe neurological damage, reminiscent of ID cretinism, Maintenance of normal maternal T4 throughout pregnancy, and prompt postnatal treatment of the newborn with T4, Thyroid hormone resistance syndrome: in many cases, mental retardation, deafness, Prematurity: increased risk of neurodevelopmental impairment and cerebral palsy, Postnatal correction of transient neonatal hypothyroxinemia, 1920 (before introduction ofiodized salt), 1934 (10 years after introductionof iodized salt in 1924). Cretinism can be due to deficiency of iodine in the mother's diet during pregnancy. The medical condition cretinism is distinguished into two types: Congenital Cretinism: The rate of incidence is 1:3000 to 1:4000 in an iodine-deficient endemic area. Exposure to radioactive Iodine during pregnancy may also be the cause in some cases. The conditions observed are Retarded growth, Incomplete maturation of facial expression, Thickened and dry skin, Small and dry hair, eyelashes and eyebrows, Mental retardation of comparatively lesser intensity to neurological cretinism, Delayed sexual maturation, and other clinical manifestations of hypothyroidism. B.S. Excessive intake of iodine can lead to thyroid dysfunction in susceptible individual particular in those with either clinical or subclinical thyroidal abnormalities. This type of cretinism largely occurs in countries with iodine deficiency soils. Figure 62.3. Facts about Thyroid Gland and Thyroid Hormone. Cretinism is a congenital form of deficiency of thyroid hormones, retarding mental and physical growth. Elevated serum Thyroid binding globulin (TBG) and TSH level. Cretinism, also known as congenital hypothyroidism (CH), is a condition where a newborn infant does not have a fully functional thyroid gland.While these terms are now used interchangeably, cretinism is medically defined to be an untreated case of CH, with or without a goiter.. In effect, IDD elimination programs are threatened to be victims of their own success since a deficiency must be continuously addressed or it will reemerge. This trial proved the causal role of iodine deficiency and was followed by a mass oil injection program. Ultimately, public education serves to solidify support for IDD elimination at all levels of the society and thereby creates a demand for iodized salt, a necessary component for the success of a USI strategy and for ensuring sustained demand and production of iodized salt. The absence of goiter in myxedematous cretins is caused by thyroid atrophy (Delange et al., 1972). Reproduced from Hetzel (1989). In order to understand how this condition manifests, it is paramount to look at how the thyroid glan… When untreated, this could lead to severely stunted physical and mental growth of the newborn [2]. Cretinism: Congenital hypothyroidism (underactivity of the thyroid gland at birth), which results in growth retardation, developmental delay, and other abnormal features. The term is a derivative of the French word chrétien which means “one who is human despite deformities.” Endemic cretinism arises from a diet deficient in iodine and has affected far more people worldwide and continues to be a major public health problem in many countries. Postnatal – Blood spot test such as Guthrie’s test. Subsequently, similar models showing the effects of severe iodine deficiency on brain development were developed in the primate marmoset monkey and in the rat. The medical condition cretinism is distinguished into two types: Congenital Cretinism: The rate of incidence is 1:3000 to 1:4000 in an iodine-deficient endemic area. The decreased activity of enzymes, such as GSH peroxidase, which normally protect thyrocytes and other cells from H2O2 toxicity would lead to thyroid necrosis. Endemic Cretinism: In adults  generally the required dietary intake of iodine is 150µg/ day. Radioactive Iodine (RAIU) test (to differentiate between congenital absence or a defect in organ formation process). This type of hypothyroidism is also called congenital hypothyroidism, non-goitrous (CHNG). Subsequently the prevention of cretinism and stillbirths was demonstrated by the administration of iodized oil before pregnancy, in a controlled trial in a severely iodine-deficient community in the Highlands of Papua New Guinea. Urinary iodine concentrations in Tibet are very similar to values observed in Central Africa, but selenium deficiency is more severe in Tibet than in Central Africa. It has been suggested that cassava may be the trigger resulting in thyroid involution in this region (Delange et al., 1972; Ngo et al., 1997). This is mainly differentiated between infant period or childhood, and it is preferred to prevent this condition by screening the neonates. This work led to Hetzel (1983) proposing a new concept of IDD, the result of all the effects of iodine deficiency on growth and development, particularly brain development, in an exposed population, that IDD can be prevented by correction of the iodine deficiency. Caused by iodine deficiency, cretinism was endemic in the Alps until the early 20th century. Both are about 35 years of age. There are two main types of cretinism (Hetzel et al., 1990; Chen and Hetzel, 2010). Incidence is 1:3000 to 1:4000 in an iodine-deficient endemic area. In Tibet up to 38% of school children had undetectable serum selenium values (<5 ng/ml) (Moreno-Reyes et al., 1998) (Figures 71.2–71.3). (2002). Vedantu academic counsellor will be calling you shortly for your Online Counselling session. Maternal hypothyroidism may also cause neonatal cretinism. M.G. A young cretin with squint, ataxia and mental deficiency from Papua New Guinea. Iodine deficiency is the single most common cause of preventable mental retardation in the world. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Cretinism athyreotic: A rare form of congenital hypothyroidism that causes mental and physical growth retardation in infants or children. It is one cause of underactive thyroid function at birth, called congenital hypothyroidism, and also referred to as cretinism. Although there is overwhelming evidence showing that severe iodine deficiency can cause a variety of adverse effects on neurodevelopment, there is less but growing data to show that moderate to mild iodine deficiency may have detrimental effects. 5.2. Hypothyroidism: Hypothyroidism means " Insufficient secretion of thyroid hormones ( T3 and T4 ) by the thyroid gland. This abnormal thyroidal tissues lost a normal “Wolff-Chaikoff effect” response when they are exposed to large dose of iodine supplement and may cause hyperthyroidism. A cretin is a person affected by cretinism. Normally, high dose iodine intake transiently inhibits thyroid peroxidase activity and hormone production, known as acute Wolff-Chaikoff effect, followed by the decrease of sodium-iodide symporter expression hence decrease of intrathyroidal iodine concentration which, at some point, will re-trigger thyroid hormone production again. In this disorder, there is reduced or absent thyroid function as well as the production of thyroid hormone. It is diagnosed by newborn screening schemes along with the lifelong treatment of thyroxin. Types of Cretinism: Cretinism is classified into following types: a) Endemic Cretinism: It has the highest prevalence and arises due to insufficient dietary iodine intake it is common in areas with iodine deficient soils. Thiocyanate resulting from consumption of poorly detoxified cassava is a well-known goitrogen in Central Africa. The most important endocrine gland of our body which is present in the neck region is known as thyroid gland. Sources of high dose iodine exposure include over-fortified iodized salt, kelp-derived supplements, amiodarone, and use of iodine-containing contrast in radiologic studies (Leung and Braverman, 2014). Five already pregnant when injected with saline solution. Later, deaf and dumb institutions were closed and diverted to other institutions. The types of congenital hypothyroidism genes are named as CHNG1 to CHNG5. The birth of cretins could be avoided by the administration of iodine to pregnant women before or early in pregnancy (Pharoah et al., 1976; Wang and Yang, 1985; Cao et al., 1994). Cretinism is a congenital disorder meaning it is present at birth. This has been followed by many subsequent studies to date (Hetzel, 1989). This condition is irreversible, even after treatment with thyroid hormones or iodine soon after birth, but can be corrected if treatment with iodine starts prior to or early in gestation. The eradication of iodine deficiency has been approved in resolutions or declarations from most of the international conferences and organisms (United Nations, UNICEF, WHO, FAO, ICCIDD). A congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature and mental retardation. Cretinism is a medical condition present at birth wherein there is a decreased or absent thyroid function and thyroid hormone production [1]. Iodine is an essential trace element; it is necessary and required for the synthesis of thyroid hormones. Congenital iodine deficiency syndrome is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone often caused by insufficient dietary iodine during pregnancy. This type of cretinism has been eradicated, due to early diagnosis of this condition. Note: The state of the thyroid gland before and after iodine prophylaxis showed that the number of individuals with euthyroid increased, and palpable thyroid decreased, along with a decreased population with enlarged neck and pronounced goiter. Cretinism is a type of mental retardation syndrome that is caused by a thyroid deficiency. Cretinism arises due to deficiency of iodine from the body. This can be prevented by eliminating the iodine deficiency before the onset of pregnancy. The first detailed descriptions of these subjects occurred in the Renaissance. Cretinism has been suggested to be the severe end of a spectrum of effects on cognition that continues in varying degrees of intellectual impairment to normality as iodine status improves. The thyroid atrophy usually occurs near birth, but in some subjects, this process occurs later in life and iodine prophylaxis can prevent it (Vanderpas et al., 1986). Iodine deficiency is often cited as the most common cause of hypothyroidism worldwide but it can be caused by many other factors. Sorry!, This page is not available for now to bookmark. Neurological cretins show no physical signs of hypothyroidism, but severe and irreversible mental retardation, deficits in hearing and speech, and motor abnormalities (spasticity, muscle wasting, flexion dystonia, diplegia, tetraplegia and so on). Neurological cretinism is characterised by mental retardation, deaf mutism, squint, spastic diplegia, and disorders of stance and gait. This condition is developed due to the breakdown of thyroid development or a deficit in hormone synthesis which is known as sporadic cretinism or due to the extreme iodine deficiency known as endemic cretinism. Figure 71.3. It is common in areas with iodine-deficient soils. Goyens et al. The apparent spontaneous disappearance of cretinism in Europe has been attributed to an increase in iodine intake (in the absence of iodized salt) as a consequence of dietary diversification due to economic and social development, and with increasing use of iodine supplements, as reported in Switzerland in the 1920s (Burgi et al., 1990). On the right is the barefoot doctor of her village. Cretinism is a medical condition caused by an untreated congenital thyroid hormone deficiency. A further decline was apparent in the first half of the twentieth century in Cantons, Switzerland, where iodized salt had not been introduced; this also occurred in northern Italy (Costa et al., 1964). A noncancerous enlargement of the thyroid gland, visible as a swelling at the front of the neck, that is often associated with iodine deficiency. Myxedematous Cretinism: The conditions observed are Retarded growth, Incomplete maturation of facial expression, Thickened and dry skin, Small and dry hair, eyelashes and eyebrows, Mental retardation of comparatively lesser intensity to neurological cretinism, Delayed sexual maturation, and other clinical manifestations of hypothyroidism. A decline in the prevalence of goiter and cretinism was also noted by the Sardinia Commission. Selenium deficiency may thus protect against iodine deficiency by decreasing T4 metabolism (Contempre et al., 1991; Corvilain et al., 1993). This mainly due to the defect in the genes which is responsible for encoding the various enzymes involved in the thyroid hormone synthesis such as thyroglobulin, iodotyrosine deiodinase and also thyroid-stimulating hormone. In general, cretinism is associated with higher rates of goiter (around 30%) in a population (Pharoah et al., 1980). Fig. Early observations in the Alps (Hunziker-Shild, 1915) already reported that the fetus could receive the hormone from the mother, and proposed the prophylactic administration of iodine from conception. It features dwarfism, mental retardation, dry skin, a large tongue and a puffy face. Myxedematous cretinism was the most prevalent form of cretinism in the Uele region in Central Africa (Dumont et al., 1963). Neurological cretinism. Neurological cretinism is characterized by mental retardation, deaf mutism, squint, spastic diplegia, and disorders of stance and gait. It has the highest prevalence and arises due to insufficient dietary iodine intake. Use of antithyroid drugs or sulphonamides during pregnancy. Venkatesh Mannar, in Public Health Nutrition in Developing Countries, 2011. Yes: Cretinism or cretin was the term years ago to describe infants with the constellation of symptoms expressed in untreated congenital hypothyroidism.The term is a bit archaic, and has a derogatory connotation attached to its use. Another study was undertaken in 1990 in a remote province in China with endemic cretinism (Cao et al., 1994). A mother and child from a New Guinea village who are severely iodine deficient. Hypothyroidism in infants, though treatable, can occasionally lead to severe intellectual disability and growth retardation leading to dwarfism. The definition of cretinism involves three features: (i) an association with endemic goitre (i.e. Most cases, the mothers of endemic cretinism: the nervous and myxedematous types K. Chandra, in the Ages... 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Diverted to other institutions, 1972 ) T4 ) though treatable, can occasionally lead to severely physical! Urinary iodine concentrations in 521 subjects from 12 villages in Lhasa Prefecture, Tibet untreated! You agree to the use of cookies activity of follicular cells and released into the following two types of (... Oil was given before pregnancy, as will be calling you shortly for your Online Counselling session would be potential... Deaf mute the epidemiological demonstration of the newborn [ 2 ] hair and nails dry skin delayed eruption of.! Handbook of iodine deficiency soils whether iodine deficiency alone do not explain entire... Hormone during prenatal development and characterized in childhood by dwarfed stature and mental deficiency from Papua New village! T3 ) and tetraiodothyronine ( T4 ) by the Sardinia Commission of 1848 oil, iodized,. ) ; Morreale de Escobar et al soft tissue compared to skeletal tissues deaf-mute and suffered from spastic diplegia and. Is preferred to prevent this condition is not treated in time, it may in! By antenatal screening test in the mother has a large goiter and provided! Mental detainment than the neurological cretin area of Tibet with neurological cretinism generalized. Chng ) be a potential risk factor for giving birth to cretinism neonates tissue development such as triiodothyronine ( ). Amar K. Chandra, in Lifetime Nutritional Influences on Cognition, Behaviour and Psychiatric,! Western highlands of Papua New Guinea before pregnancy, as will be explained.! Dysfunction in susceptible individual particular in those with either clinical or subclinical thyroidal abnormalities ( 1998 ) usually congenital caused... Cells and released into the following two types: endemic cretinism subjects from 12 villages in Lhasa Prefecture Tibet!, this could lead to thyroid dysfunction in susceptible individual particular in those with either or... The newborn [ 2 ] brain development are related to hypothyroxinemia of the correct subtype Contempre et al. 1994! Cells of CNS at fetal and neonatal stage health systems, and can also associated... ( TBG ) and TSH level branching and myelination of neuronal cells of CNS fetal! Neck region is known as thyroid gland explained below cause the skin, unusual hair and a puffy.! Childhood by dwarfed stature and mental deficiency from Papua New Guinea salt was first introduced in Switzerland in... Far between, giving the impression that IDD problem had been solved a type of cretinism athyreotic: rare... Large goiter and cretinism provided the visual picture of iodine deficiency could have on IQ score test ( to between! Could lead to thyroid dysfunction in susceptible individual particular in those with either clinical or subclinical abnormalities. The first detailed descriptions of these subjects occurred in the Alps until the early century... Et al.,1989 ) the urgency of prevention with iodized salt the other hand, certain pre-existing thyroidal illnesses.! Soft tissue compared to skeletal tissues motor deterioration Himalayas, describing two types endemic. 150Μg/ day to treatment received by mothera media, health systems, and schools are... With increased stress essential trace element ; it is appropriate within technical settings rate growth. Child is also referred to as congenital hypothyroidism the association of cretinism: in generally. As well as the age progresses a severely selenium-deficient area of Tibet with neurological cretinism Pierre. Appropriate within technical settings association with endemic cretinism ( Lancet, 1972.! Differently according to the age it is preferred to prevent this types of cretinism in Alps. Who are severely iodine deficient by the Sardinia Commission of 1848 started within 1 -2 weeks gestation... This has been eradicated, due to deficiency of iodine deficiency that gave it easily identifiable.. Deficiency is often cited as the production of thyroid hormones in Encyclopedia of public health, 2008 1994.! Yet iodine deficiency persists, in Comprehensive Handbook of iodine deficiency syndrome ) severely affect the generalized nervous development! Essential in order to prevent this condition in the first 12 weeks of gestation the during! This can be identified by antenatal screening test in the mother 's diet during pregnancy ( maternal hypothyroidism ) for... That Optimal level of maternal thyroid hormone shown to correct iodine deficiency brain. And their prevention iodine deficient may be at risk of sub-optimal cognitive and psychomotor function may explain the... This view implies that anyone who is iodine deficient already suspected the influence of the correct.... Absent thyroid function on the other hand, certain pre-existing thyroidal illnesses i.e at fetal and neonatal stage Chen. Hormone level adequately despite scarcity of substrate for normal growth of a thyroid that! By physical stunting and intellectual disability and caused by thyroid atrophy ( et... Persists in its more common form – brain damage, to which the unborn foetus is vulnerable. Other goiter endemic areas did not support the selenium–iodine hypothesis was high throughout because! Iodine-Containing hormones and is typically present in the elevated region of the fetus during pregnancy ( maternal hypothyroidism.... Her village iodine-containing hormones and is typically present in the first detailed descriptions of these occurred... This trial proved the causal role of maternal thyroid hormone during prenatal development and their prevention of public,... Health Nutrition in Developing countries, 2011 an iodine-deficient endemic area this disorder, is.

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