Cretinism in a child - signs and symptoms, basic treatment methods

When wondering what cretinism means, we should note the primary disruption of the endocrine system. This deviation manifests itself in the form of mental and physical retardation of a person. Unlike schizophrenia and other types of psychological disorders, cretinism occurs solely against the background of hormonal imbalance. The exchange of thyroid hormones is disrupted due to improper functioning of the thyroid gland. As a result, the body begins to work incorrectly.

Causes

The disease occurs as a result of damage to the enzyme systems that ensure the synthesis and exchange of thyroid hormones (thyroid hormones), which leads to the development of sporadic non-toxic goiter and hypothyroidism.
Causes of cretinism:

• hereditary factor (impaired iodine intake, thyroid-stimulating hormone reaction);
• violation of embryonic development of the thyroid gland;
• athyroidism (absence of the thyroid gland);
• hypoplasia of the thyroid gland;
• ectopia of the thyroid gland;
• treatment of a pregnant woman with radioactive iodine and thyreostatic drugs;
• consequences of endemic goiter suffered during pregnancy.

Sources

1. Osokina I.V. Epidemiology of iodine deficiency diseases in Siberia. 2005. Pacific Medical Journal;
2. Sviridonova M. A. Iodine deficiency, formation and development of the body. 2014. Clinical and experimental thyroidology;
3. Platonova Nadezhda Mikhailovna Iodine deficiency: current state of the problem. 2015. Clinical and experimental thyroidology;
4. Kochergina I.I. Endemic goiter and other iodine deficiency diseases. 2008. Medical Council;
5. Petunina N.A., Telnova M.E. Iodine deficiency diseases: a modern approach to prevention Petunina N.A., Telnova M.E.. 2016. Gynecology;
6. Sapozhnikova I. E., Nemtsov B. F. Iodine deficiency: current state of the problem. 2007. Vyatka Medical Bulletin.

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Symptoms of cretinism

Symptoms characteristic of cretinism are:

• bone changes (dwarfism, underdevelopment of the cranial vault, skull deformation, thickening of the frontal and parietal bones);
• reduction in the volume of internal organs;
• lack of muscle tone;
• dysfunction of the gonads;
• thickening of the skin;
• hearing and speech impairment, reaching deaf-mute;
• attacks of suffocation;
• mental disorder;
• increase in size, prolapse of the tongue;
• lethargy;
• coordination problems;
• drowsiness.

If you experience similar symptoms, consult your doctor

. It is easier to prevent a disease than to deal with the consequences.

How to determine the presence of a deviation in children of different ages

Children may suffer from the described disease with the following expression:

— Unstable and insufficient development of the muscular system and skeleton of the body; — Unstable blood circulation in the spinal cord; — Reduced quality of protein absorption in the body.

All this is determined visually at the moment of birth. Firstly, violations are often indicated by the child’s excess weight (over 4 kilograms). Secondly, the umbilical cord will take longer to fall off. Thirdly, the child’s body will be weak. The baby will constantly sleep and not want to eat food. His body will be weak, and the muscular system will not fully work and support the head and limbs.

It is very important at this stage not to confuse the general condition of the newborn child with that characterized by infantile cretinism. Visually, the disorder is also noticeable. The development of the body in this case occurs disproportionately. For example, the torso can increase in size, but the limbs do not. Also, fluid begins to accumulate under the skin and swelling appears. All this indicates a disruption of the endocrine system and it is necessary to immediately begin a comprehensive medical examination.

Prevention

Among the preventive measures, it is worth remembering the following:

• Since cretinism often develops in marriage between close relatives, such unions are unacceptable.
• If a family lives in an area unfavorable in terms of iodine levels, it is sometimes advisable to move to another area. This especially applies to those cases where frequent cases of goiter in children have been identified in the area.
• It is necessary to monitor the quality of drinking water. If it's bad, consider buying bottled drinking water.
• If you have iodine deficiency, you should consume iodized salt and foods containing it.
• During pregnancy, the diet must include foods rich in iodine (feijoa, cod liver, seafood, champignons, dairy).
• Children are prescribed vitamin D and a preparation with iodine for prevention. They strengthen bones well and prevent rickets from developing. Natural feeding is also recommended. Breast milk contains a whole complex of vitamins and microelements.

Problems with the thyroid gland do not exclude the possibility of pregnancy and pregnancy. A prerequisite for this is constant monitoring by an endocrinologist.

Only for women?

No matter how we tried to dispel the stereotype that in most cases women suffer from topographic cretinism, it did not work - scientists only confirmed it to us. For women, the speed and efficiency of thinking does not always work with a bang when it comes to routes from point A to point B.

“The key visual-spatial functions in men are concentrated in the right hemisphere, but in women these functions are “spread out” across two hemispheres and this is not so effective,” said Tatyana Akhutina, Doctor of Psychology, specialist in the field of neuropsychology and psycholinguistics.

There is also an evolutionary explanation. Perhaps the cause of female topographic cretinism should be sought back in the cave era. Women in ancient times never had to hunt, go on long hikes, or navigate by the stars. These were men's tasks, while women sat in their dwellings and picked berries seven steps from the cave.

However, there are also men who cannot always find their way home on their own. One of these is Yuri Alexandrov, who therefore began studying this issue.

“I personally have topographical cretinism, and I know from my own experience how terrible it is when my wife leads me and shows me where to turn,” Aleksandrov laughs.

Sometimes parents can be to blame for topographic cretinism, both literally and figuratively.

When, for example, a left-hander is actively retrained, at some point he may begin to confuse right and left, and later he may even become a topographical cretin. In addition, genes may be to blame for impaired spatial orientation skills. So pay attention to your parents, there is a theory that the “disease” is inherited.

What is the prognosis for patients?

Cretinism is an extremely dangerous disease, as it can even lead to disability. However, most often with early diagnosis and proper treatment, the patient can be helped. Normalizing the functioning of the thyroid gland and pituitary gland leads to the elimination of metabolic disorders.

However, complications cannot be avoided in all cases. For example, if therapy is started late, brain damage remains. And some genetic diseases are difficult to treat even with symptomatic treatment.

Why does the body need iodine?

Iodine can prevent the development of this pathology. If the function of thyroid hormone production is impaired, the child develops an acute iodine deficiency over time.

A normal level of iodine in a pregnant woman’s body is extremely important. This is the key to health and proper development of the fetus. This element is involved in the formation of the nervous system. If a deficiency develops, pathologies in the development of the inner ear, even the cerebral cortex, occur. If the cortex is formed incorrectly, the child incorrectly builds associations on which the entire thinking process is subsequently built. If there is a pathology in the development of the inner ear, deafness is observed. Violation of spinal motility entails the development of spasm, movements become slow, and immobility occurs over time.

Forecast

Most often, with timely treatment, one can hope for a favorable outcome.

An unfavorable prognosis will occur if:

1. body cells are insensitive to thyroid hormones;
2. A malignant tumor causing hypothyroidism was identified.

So, cretinism is not an offensive insult, but a medical diagnosis. It must be taken very seriously. To avoid encountering such a pathology, you should think about preventive measures in a timely manner. Adding iodized salt to salads and dishes significantly reduces the risk of disease.

Map in my head

When we walk over the same area every day for a long time, a cognitive map is formed in our heads - this is the scientific term for the construction of three-dimensional maps in the human brain, which allow us to quite accurately mentally visualize the route.

Interestingly, it is not necessary to see the road. So, in 1998, scientists from Russia conducted an experiment to find out how visual memory affects the preparation of a route in the head. Blind and sighted people took part in the study. They were divided into two groups (each included both categories), which spent 10 days exploring the territory: for only one group it was a familiar area, for the other it was completely new.

The researchers later compared the cognitive maps of each participant in the experiment. The results showed that sighted people had the most accurate maps in unfamiliar areas. However, in familiar territory, the blind were distinguished by the accuracy of the maps. The fact is that blind people cannot use visual orientation. In fact, they calculate their every step and therefore can then easily reproduce the entire route.

Inattention

Many people, walking in new places, are completely immersed in their thoughts or talking on the phone and do not consider it necessary to remember their route. Memory development specialist Larisa Chetverova advises practicing a simple exercise that will help improve attentiveness.

— Any abilities can be developed to a greater or lesser extent. You need to train your attention. Learn to write with both hands - this is a powerful exercise for developing memory: for example, writing “mom” with one hand and “dad” with the other. Definitely at the same time: one hand does not wait for the other,” Chetverov shares his advice.

Treatment

Therapy begins immediately. We must not waste time, because the consequences are irreversible. Timely initiation of qualified treatment is the key to a positive prognosis in the future .
If hypothyroidism is established, replacement therapy is carried out. The patient is prescribed synthetic hormones that will help replace lost thyroid function. This group of drugs is prescribed for all forms, except in cases where the tissues are insensitive to the hormones produced by the thyroid gland.

Sometimes it happens that the clinic does not have the conditions for a full diagnosis of the disease. If there are clear signs of cretinism, the doctor may prescribe urgent treatment without a full diagnosis and taking all tests. The doctor then takes into account how the patient’s body responds to the therapy.

Treatment begins immediately, in the first month after birth. Proper therapy allows the baby’s body to develop normally. If treatment is delayed (started after 4-6 weeks), the likelihood that the child will experience a number of severe symptoms of cretinism increases significantly.

Drugs

The following drugs are used in pediatrics: