This is a condition due to inadequate secretion of thyroid hormones during fetal life or early infancy. The brain and skeleton fail to develop properly, resulting in mental retardation and dwarfism. It is due to congenital deficiency in the secretion of hormone thyroxine from the thyroid gland. It is caused due to insufficient amount of iodine in the diet of the child?s mother during pregnancy.

Congenital hypothyroidism (Cretinism)

Radiographic appearance of cretinism:

In cretinism the base of skull is foreshortened, face is wide and short, mandible underdeveloped. It is identified both clinically and with lateral cephalometric radiographs. The eruption of primary and permanent teeth is delayed.
The long bones are thickened and short, the epiphyses appear late and ore often irregular and deformed.
It is a condition of stunted body growth and impaired mental development.

Most affected infants have few or no symptoms, because they only have a mild decrease in thyroid hormone production. However, infants with severe hypothyroidism often have a distinctive appearance.

Symptoms may include:

• Puffy-appearing face
• Dull look
• Thick, protruding tongue
• This appearance usually develops as the disease gets worse. The child may also have:
• Dry, brittle hair.
• Low hairline.
• Jaundice .
• Poor feeding .
• Choking episodes.
• Lack of muscle tone (floppy infant).
• Constipation.
• Sleepiness.
• Sluggishness.
• Short stature Gradual development of coarse, dry skin.
• Slightly swollen face and tongue.
• Umbilical hernia.
• Open mouth that drools.
• Baby will be listless, slow moving.
• Slow feeder.

Diagnosis:

• Thyroid tests in new born.
• X-rays of the skull and long bones.
• Thyroid scan.

Treatment:

Treatment with thyroid hormone promotes normal physical and mental development. It is essential that treatment be started during the first six weeks of life or irreversible changes may take place.

Complications:

• Mental retardation.
• Growth retardation.
• Heart problems.