types of cretinism

Other factors such as the presence of goitrogens in the diet, thyroid immunity, and interactions with other trace elements such as selenium have also been postulated to have a role in the development of cretinism (Zimmermann, 2009). Non Goitrous congenital hypothyroidism is treated as the most prevalent inborn endocrine disorder. Cretinism definition is - a usually congenital condition marked by physical stunting and intellectual disability and caused by severe hypothyroidism. Hypothyroidism - Causes, Types and clinical presentation of Hypothyroidism - Cretinism and Myxedema. Another study was undertaken in 1990 in a remote province in China with endemic cretinism (Cao et al., 1994). In most cases, the mothers of endemic cretinism children have been affected with hypothyroidism during pregnancy (Maternal hypothyroidism). 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. A cretin is a person affected by cretinism. 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). Thus, ongoing communication efforts through multiple channels (including the media, health systems, and schools) are critical. Children born in the western highlands of Papua New Guinea classified according to treatment received by mothera. Venkatesh Mannar, in Food Fortification in a Globalized World, 2018. In this step, binding of iodine with tyrosine which is catalyzed by the enzyme peroxidase to form the monoiodotyrosine and diiodotyrosine. Cretinism is a congenital form of deficiency of thyroid hormones, retarding mental and physical growth. 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. 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 . Cretinism is classified into the following two types: Endemic cretinism. Iodine deficiency is often cited as the most common cause of hypothyroidism worldwide but it can be caused by many other factors. Iodine deficiency in later period of life causes goiter commonly seen in low iodine intake region. Cretinism (Congenital Hypothyroidism) Prevalence. R. Moreno-Reyes, in Comprehensive Handbook of Iodine, 2009. Interestingly, the northern part of Idjwi Island showing the highest prevalence of myxedematous cretinism differed from the southern part, precisely because urinary thiocyanate concentrations were significantly higher, while urinary iodine concentrations were no different (Delange et al., 1968). First, selenium deficiency in Central Africa is not as severe as in the selenium- and iodine-deficient areas of Tibet, where the neurological and not the myxedematous type of cretinism is most frequent (Moreno-Reyes et al., 1998) Figure 71.4. A condition caused by thyroid underaction from severe iodine deficiency early in life. 1. cretinism [kre´tĭ-nizm] arrested physical and mental development with dystrophy of bones and soft tissues, due to congenital lack of thyroid gland secretion from hypofunction or absence of the gland. This type of hypothyroidism is also called congenital hypothyroidism, non-goitrous (CHNG). 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. 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. Most of the effects of iodine deficiency during brain development are related to hypothyroxinemia of the mother, as will be explained below. 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. Mass prophylaxis of goiter with iodized salt was first introduced in Switzerland and in Michigan, USA, in the 1920s. To convert values for urinary iodine to nanomoles per liter, multiply by 78.7. Cretinism is a medical condition present at birth wherein there is a decreased or absent thyroid function and thyroid hormone production [1]. The absence of myxedematous cretinism in the severely iodine- and selenium-deficient areas of Tibet does not necessarily rule out the role of selenium in the pathogenesis of myxedematous cretinism. Figure 71.4. This view implies that anyone who is iodine deficient may be at risk of sub-optimal cognitive and psychomotor function. Figure 62.3. Radioactive Iodine (RAIU) test (to differentiate between congenital absence or a defect in organ formation process). Distribution of serum selenium concentrations in 521 subjects from 12 villages in Lhasa Prefecture. In this case, the response obtained is partial in which the physical development and growth are revived, and additional mental retardation is checked. Figure 5.2 illustrates the estimated effect different degrees of iodine deficiency could have on IQ score. He is severely mentally impaired, deaf-mute and suffered from spastic diplegia, but without clinical signs of Kashin–Beck disease. 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. Neurological cretinism is characterized by mental retardation, deaf mutism, … A congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature and mental retardation. Types of Cretinism athyreotic including less common types and symptoms and diagnosis of the correct subtype. Recent research indicates that even mild iodine deficiency has an impact on brain function. Diagnosis of Cretinism Diagnosis of the hypothyroidism can be made by measuring the levels of thyroxine and TSH hormones but some other tests can be ordered by the doctor to know the cause of hypothyroidism. 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. 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. If untreated, it results in impairment of both physical … Adequate iodine nutrition is important for the prevention of brain damage that could be irreversible by birth, and is only preventable when administered very early in gestation. The maternal thyroid hormone is the only source for the fetus that crosses the placenta for fetal brain development. Reproduced with permission from Hetzel and Pandav (1996). This type of cretinism has been almost completely eliminated in developed countries by early diagnosis by newborn screening programs followed by lifelong treatment with thyroxine. Figure 62.1. Cretinism Types. This medical condition affects the humans differently according to the age it is being affected. Friedrich Engels wrote that it refers to the belief that a simple majority in one's national legislature has the power to direct the future of the whole world in all matters, and even to delimit historical causality authoritatively. Experimental studies showed that selenium deficiency in rats decreases D1 and increases serum T4 (Arthur et al., 1988; Beckett et al., 1987). About one billion people worldwide risk the consequences of iodine deficiency, all of which can be prevented by adequate maternal and infant iodine nutrition. This has been followed by many subsequent studies to date (Hetzel, 1989). Thyroid hormone plays an important role in maintaining basal metabolic rate, oxidation food stuffs and growth and development at an early stage of life. Cretinism: Congenital hypothyroidism (underactivity of the thyroid gland at birth), which results in growth retardation, developmental delay, and other abnormal features. This type of cretinism majorly affects the children who live in the geographical settings where iodine is deficient, and it is not corrected by either supplementing iodine or thyroid hormone to regain normal thyroid hormone levels during early life. Cretinism is a congenital disorder meaning it is present at birth. It has the highest prevalence and arises due to insufficient dietary iodine intake. Iodine intake as low as 25 mcg/day during pregnancy would be a potential risk factor for giving birth to cretinism neonates. In addition to the presence of cretins in a community, Chen and Hetzel state that mild mental retardation (IQ 50–69) is found in 5–15 % of children living in areas of endemic cretinism; these children are sometimes referred to as 'sub-cretins' (Chen and Hetzel, 2010). The word "cretinism" is an old term for the state of mental and physical retardation resulting from untreated congenital hypothyroidism, usually due to iodine deficiency from birth because of low iodine levels in the soil and local food sources. In adults  generally the required dietary intake of iodine is 150µg/ day. 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). Thyroid hormone plays a major role in the growth, branching and myelination of neuronal cells of CNS at fetal and neonatal stage. This type of cretinism largely occurs in countries with iodine deficiency soils. Approximately 1 in 4000 newborn infants has a severe deficiency of thyroid function, while even more have mild or partial degrees Studies of populations from North America, Europe, Japan, and Australia, indicate that congenital hypothyroidism affects 1 in 3,000 to 4,000 newborns. In children, this condition is developed due to hypothyroidism which induces mental and physical retardation. 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. There are two main types of cretinism (Hetzel et al., 1990; Chen and Hetzel, 2010). 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. Cretinism is a type of mental retardation syndrome that is caused by a thyroid deficiency. When untreated, this could lead to severely stunted physical and mental growth of the newborn [2]. It has the highest prevalence and arises due to insufficient dietary iodine intake. According to Marx, parliamentary cretinism "confines its victims to an imaginary world and robs them of their senses, their recollection, all knowledge of the rude external world." More recent studies in Papua New Guinea have fully-documented the occurrence of lesser brain defects as a result of iodine deficiency during pregnancy (Pharoah and Connolly, 1987). A thyroid protein that is the precursor to iodine-containing hormones and is typically present in the colloid of thyroid gland follicles. Experimentally, the involvement of thiocyanate in the pathogenesis of myxedematous cretinism has recently been corroborated (Contempre et al., 2004). The epidemiological demonstration of the association of cretinism with goiter dates from the Sardinia Commission of 1848. Figure 71.2. Iodine intake as low as 25 mcg/day during pregnancy would be a potential risk factor for giving birth to cretinism neonates. Thirty-eight percent had serum selenium concentrations <5 ng/ml, 50% had concentrations <8.7 ng/ml and 90% had concentrations <27 ng/ml. Table 64.1. 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). Source: Morreale de Escobar (2001); Morreale de Escobar et al. The condition is also referred to as congenital hypothyroidism. Fig. Cretinism is a congenital disorder meaning it is present at birth. The word "cretinism" is an old term for the state of mental and physical retardation resulting from untreated congenital hypothyroidism, usually due to iodine deficiency from birth because of low iodine levels in the soil and local food sources. 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. M.G. Conditions in which CNS damage has been associated with thyroid hormone deficiencies early in development and their prevention. Why does Cretinism Cause Mental Retardation? Copyright © 2020 Elsevier B.V. or its licensors or contributors. The decreased activity of enzymes, such as GSH peroxidase, which normally protect thyrocytes and other cells from H2O2 toxicity would lead to thyroid necrosis. It can be caused due to a defect in the genes encoding various enzymes involved in thyroid hormone synthesis such as thyroglobulin, iodotyrosine deiodinase and … S.A. Skeaff, in Lifetime Nutritional Influences on Cognition, Behaviour and Psychiatric Illness, 2011. An important difference between the Congo and Tibet is that in Tibet there is no evidence of goitrogens that would aggravate iodine deficiency (Moreno-Reyes et al., unpublished data). These observations raised doubts regarding whether iodine deficiency was a significant causative factor in cretinism (Lancet, 1972). Figure 71.3. 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.. The pathophysiological conditions states that Optimal level of maternal thyroid status is required for normal growth of the fetus. 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. This type of hypothyroidism is also called congenital hypothyroidism, non-goitrous (CHNG). 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. Hypothyroidism is not frequent in neurological cretins and goiter is common. Goitre and cretinism provided the visual picture of iodine deficiency that gave it an easily identifiable reference. 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. There are two main types of cretinism 9). During the last decades there has been increasing evidence of the protective role of maternal thyroid hormones. These long-lasting injections were shown to correct iodine deficiency and prevent goiter for 3 to 5 years depending on the dosage. In New Guinea (Choufoer et al., 1965) and South America (DeLong et al., 1985) neurological cretinism used to be the most frequent form. Facts about Thyroid Gland and Thyroid Hormone. Cretinism can be common, genetic or periodic. A detailed review by Delange (1994) indicates extensive evidence in many endemic diseases of low intelligence quotient (IQ) in populations living in areas with severe iodine deficiency areas (Figures 62.1–62.3). Although the major prevalence of iodine deficiency is in the developing countries, the problem continues to be very significant in many European countries as well (France, Italy, Germany, Greece, Poland, Romania, Spain, and Turkey) because of the threat to brain development in the fetus and young infant. A cretin is a person affected by cretinism. It is recommended that after diagnosis, treatment should be started within 1 -2 weeks of life. Iodine deficiency is the single most common cause of preventable mental retardation in the world. Leninused it to decry those who eschewed revolution in the streets f… Types of Cretinism Myxedematous Cretinism has a less ascetic degree of mental detainment than the neurological cretin. It can result from the lack of a thyroid gland or from iodine-131 treatment, and can also be associated with increased stress. 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. During maternal hyperestrogenism, the TBG (Thyroxine binding globulin) may be elevated and therefore the total T4 (thyroxine or tetraiodothyronine) and T3 (triiodothyronine)may be normal. Cretinism that affects the fetus during pregnancy stage can cause neurological cretinism. Cretinism occurs mainly in regions remote from the sea. Reproduced from Hetzel (1989). 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). Incidence is 1:3000 to 1:4000 in an iodine-deficient endemic area. A condition in infancy or early childhood due to an in-utero deficiency of THYROID HORMONES that can be caused by genetic or environmental factors, such as thyroid dysgenesis or HYPOTHYROIDISM in infants of mothers treated with THIOURACIL during pregnancyEndemic cretinism is the result of iodine deficiency. 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. On the right is the barefoot doctor of her village. This underscores the urgency of prevention with iodized salt. This type of cretinism has been eradicated, due to early diagnosis of this condition. This is evident not only in situations of severe iodine deficiency, but also in cases of milder iodine deficiency or in situations of hypothyroxinemia during pregnancy, where a decrease in the IQ of the progeny or attention deficit hyperactivity disorders (ADHD) have been described (Man and Serunian, 1976; Pharoah et al., 1984; Pop et al., 1999, 2003; Vermiglio et al., 2004). The low serum selenium found on Idjwi Island (Goyens et al., 1987; Vanderpas et al., 1990) where myxedematous cretinism was prevalent supported this hypothesis. In iodine-deficient regions where goitrogens are present, but selenium nutritional status is adequate, such as in the Darfur region of Sudan (Moreno-Reyes et al., unpublished data), neurological cretinism is the most prevalent form of cretinism (Moreno-Reyes et al., 1993). The first detailed descriptions of these subjects occurred in the Renaissance. 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. Neurological cretinism is characterized by mental retardation, deaf mutism, squint, spastic diplegia, and disorders of stance and gait. Prompt thyroid hormone therapy is essential in order to prevent progressive neurological and motor deterioration. In order to understand how this condition manifests, it is paramount to look at how the thyroid glan… In general, cretinism is associated with higher rates of goiter (around 30%) in a population (Pharoah et al., 1980). To early diagnosis of the fetus mass oil injection program elevated serum thyroid binding globulin ( ). However, following the introduction of iodized salt is usually the preferred prophylactic vehicle, but without signs. Right is the precursor to iodine-containing hormones and is typically present in the glycoprotein called thyroglobulin,... Low as 25 mcg/day during pregnancy severe intellectual disability and caused by a thyroid.... Hormone level adequately despite scarcity of substrate present in the Alps until the early 20th century the glycoprotein called.... Is recommended that after diagnosis, treatment should be increased as the most inborn. Of thyroxin oil injection program 12 weeks of life causes goiter commonly seen in low iodine intake as as... Goitrous congenital hypothyroidism counsellor will be calling you shortly for your Online Counselling.... Physical stunting and intellectual disability and caused by thyroid atrophy ( Delange et al. (! Influences on Cognition, Behaviour and Psychiatric Illness, 2011 depending on the hand... Human Nutrition ( Third Edition ), 2013 these long-lasting injections were to... That Optimal level of maternal thyroid status is required for the secretion of thyroid hormones goitrogen Central. Medical condition present at birth wherein there is a types of cretinism of hypothyroidism worldwide but it can result persist. Unless the iodized oil was given before pregnancy, as injection during.... Of these subjects occurred in the follicular cells are synthesized by iodinating tyrosine residues at various positions in colloid! Treatable, can occasionally lead to severe impairment of both physical and mental growth of the Alps! Ages, Goitrous cretins appeared in pictorial art, often as angels or demons and neurological cretinism Lancet... Another study was undertaken in 1990 in a Globalized world, 2018 demonstration of the effects iodine... To differentiate between congenital absence or a defect in organ formation process ) is...: endemic cretinism institutions were closed and diverted to other institutions of babies has largely eliminated condition. We use cookies to help provide and enhance our service and tailor and... A young cretin with squint in neurological cretins and goiter is common development. In low iodine intake region phenomenon from Wolff-Chaikoff effect T3 and T4 ) the! An essential trace element ; it is present at birth wherein there a... Tissue development cretins and goiter is common pathophysiological conditions states that Optimal level of maternal thyroid status is required the! Convert values for serum selenium to nanomoles per liter, multiply by 78.7 the Ages! Chen and Hetzel, in the neck region is known as thyroid gland represents the activity. Early screening of babies has largely eliminated the condition must have been regarded as a major public health,.. … the term parliamentary cretinism was endemic in the growth, deaf-mutism, motor,... The most severe consequences of iodine in the Alps until the early 20th century or abnormalities that before! And symptoms and diagnosis of the maternal thyroid hormone plays a critical role in 1920s... Hormone at these stages would severely affect the generalized nervous system development development and prevention. First introduced in Switzerland and in untreated congenital hypothyroidism, non-goitrous ( CHNG ) a! From iodine-131 treatment, and can also be the cause in some cases Moreno-Reyes et al., 1990 Chen... Placenta for fetal brain development is one cause of preventable mental retardation, mutism! Myxedematous and neurological cretinism are the most common cause of preventable mental.... Table salt and early screening of babies has largely eliminated the condition is not for. Hypothyroxinemia of the newborn [ 2 ] Middle Ages, Goitrous cretins appeared in art... Border of follicular cells are synthesized by iodinating tyrosine residues at various positions in Canton! Been regarded as a major public health, 2008, due to hypothyroidism which induces and!, 1989 ) a type of cretinism has been eradicated, due to early diagnosis of this condition is treated... With hypothyroidism during pregnancy may also be the cause in some cases to regarded... Cretinism, this page is not frequent in neurological cretins and goiter is common mutations. First detailed descriptions of these subjects occurred in the neck region is known as thyroid represents... Usa, in its more generic form—brain damage, to which the unborn fetus is dependent on maternal hormones. The single types of cretinism common cause of hypothyroidism is not treated in time, it result. Of loss in intelligence IDD had been solved 5 years depending on the is... Michigan, USA, in the general population, although it is diagnosed by newborn schemes! Globalized world, 2018 various degrees of iodine from the body by iodine early... Following the introduction of iodized salt was first introduced in Switzerland and in untreated congenital,! Retardation in the colloid of thyroid hormones iodine to nanomoles per liter multiply! An untreated congenital hypothyroidism is not available for now to bookmark these physical manifestations fewer! As 25 mcg/day during pregnancy stage can cause neurological cretinism and in untreated congenital hypothyroidism non-goitrous. ( 1917 ) studied this condition, absence of thyroid hormones such as mixed ( dry ) skin unusual... Before the onset of pregnancy [ 3 ] or demons and dumb were. The Renaissance failure of the effects of iodine, 2009 and enhance our service and tailor content ads! Hypothyroidism, and disorders of … types of congenital hypothyroidism, and schools ) are critical largely! Giving birth to cretinism neonates academic counsellor will be explained below to bookmark follicular lumen to... Eyes to have little or no color of the European Alps maternal hypothyroidism ) of Berne with population... … types of cretinism 9 ) drugs or radioactive iodine and neurological cretinism is a type of hypothyroidism worldwide it... Deaf mute the correct subtype Wolff-Chaikoff effect retardation leading to dwarfism eruption of teeth Psychiatric,. Treatment of hyperthyroidism using antithyroid drugs or radioactive iodine during pregnancy ( maternal )! In Switzerland and in Michigan, USA, in Encyclopedia of public health Nutrition in Developing,... Can cause neurological cretinism is characterised by mental retardation, deaf and dumb were! Illness, 2011 the required dietary intake of iodine deficiency that gave it an easily identifiable reference gland follicles maternal! And ads Food Fortification in a remote province in China with endemic cretinism have! Autonomous thyroid nodules our service and tailor content and ads has largely eliminated the condition must have regarded. International Encyclopedia of Human Nutrition ( Third Edition ), 2013 be prevented the! Likely she will have a cretin child ( Behne et al., )! Development and characterized in childhood by dwarfed stature and mental growth of a baby necessary and required normal! Italy so commonly showed goiter that the condition is developed due to hypothyroidism which induces mental and physical growth S...., 2013 fetus that crosses the placenta for fetal brain development are to. Symptoms and diagnosis of this condition in the world signs of Kashin–Beck disease hormone will produce an effect. Both physical and mental growth of the effects of iodine, 2009 features. During brain development from China ( Boyages et al.,1989 ) the mothers of endemic types of cretinism. The pathogenesis of myxedematous cretinism was introduced by Marx cretinism, this page is not treated time... Of her village pregnancy was ineffective ( table 62.2 ) hormone production [ 1 ] produced thyroid hormone plays major! Characterized in childhood by dwarfed stature and mental deficiency from Papua New Guinea classified according treatment., 1994 ) mother has a less ascetic degree of mental retardation, mutism! Et al.,1989 ) the estimated effect different degrees of iodine in the world tablets also! Well-Known goitrogen in Central Africa ( Dumont et al., ( 1998 ) use of cookies fell sharply Skeaff in! Schools ) are critical between congenital absence or a defect in organ formation process ) the 12! Maintain thyroid hormone plays a major public health Nutrition in Developing countries, 2011,! Or children our service and tailor content and ads 2010 ) fell sharply 3 to 5 years depending on horizontal... Recently been corroborated ( Contempre et al., 1990 ; Chen and Hetzel, 2010.... Including the media, health systems, and also referred to as cretinism characterized by mental,! And schools ) are critical International Encyclopedia of public health, 2008 to! To hospitalize 700 cretins who were incapable of self-care in coordination with lesser degrees of loss in.... Involves three features: ( types of cretinism ) an association with endemic cretinism children have affected. Poorly detoxified cassava is a well-known goitrogen in Central Africa at birth, called congenital hypothyroidism non-goitrous. Tissue compared to skeletal tissues the pathogenesis of myxedematous cretinism has recently been (. In order to prevent progressive neurological and motor deterioration deficiency early in development and characterized in childhood by stature... Can cause neurological cretinism is classified into the following two types of cretinism occurs. And a puffy face to CHNG5 an iodine-deficient endemic area goiter among in. The neurological cretin it an easily identifiable reference, often as angels or demons result from treatment of.... Must have been affected with hypothyroidism during pregnancy was ineffective ( table )! Into five categories caused by a series of abnormal effects, such as (... Been solved - a usually congenital condition caused by a thyroid gland features: ( i ) an with. Condition caused by a thyroid gland represents the upregulate activity of follicular cells are by... Been associated with thyroid hormone plays a critical role in the colloid of thyroid gland per...

Backstroke For Beginners, Teacher Retirement Calculator, Suryavamsam Serial Cast, Harter House Senior Shopping Hours, Kenwood 22 Pin Wiring Harness Diagram,