Cretinism, one of the dangerous congenital malnutrition groups

There are several types of diseases that fall into the group of malnutrition, cretinism is one of them. The name is uncommon, but this condition is a disorder that is inherited from birth. The following is an explanation about cretinism that needs to be known.

What is cretinism?

In the Indian Journal of Endocrinology and Metabolism, cretinism is a condition of severely stunted physical and mental growth due to a congenital disease of hypothyroidism that cannot be treated.

Cretinism, now known as congenital or congenital hypothyroidism, affects newborns the worst. This causes neurological dysfunction, stunted growth, and physical abnormalities.

This condition can occur due to a problem with the baby's thyroid gland or a lack of iodine in the mother's body during pregnancy.

The baby's body needs iodine to form thyroid hormones. How important is this hormone? Thyroid hormone functions for brain growth and nervous system development.

In a journal published by the Orphanet Journal of Rare Disease, it shows that 1 in 2000 babies, are born with congenital cretinism or hypothyroidism.

In the early 20th century the introduction of iodized salt was still very rare, this is what made congenital hypothyroidism so rampant, especially in developing countries.

What causes cretinism?

The main cause of cretinism is a lack of iodine supply in the womb. The following is an explanation of the explanation of cretinism in children:

Lack of iodine

As previously mentioned, pregnant women who are deficient in iodine put the fetus at risk for congenital hypothyroidism.

Lack of iodine causes the production of thyroid hormone to decrease in the body, this triggers cretinism.

In addition, iodine deficiency also causes the child to have a genetic defect that affects the production of thyroid hormones during pregnancy. In addition, the use of antithyroid drugs for thyroid cancer patients also affects genetic defects.

The condition of the thyroid gland is abnormal

If the condition of the child's thyroid gland is smaller than normal, swollen, or even lost, it can be the cause of cretinism in children.

Thyroid gland damage is still related to the insufficient supply of iodine in pregnant women and is a source of damage to the child's neurological function.

The thyroid gland requires iodine for hormone production. When the body is deficient in these substances, the immune system will force the thyroid gland to work harder.

This in turn leads to enlargement of the thyroid gland and results in swelling of the neck.

The influence of drugs

If the mother takes drugs during pregnancy, pay attention to the contents. There are several drugs that interfere with the production of thyroid hormones.

These drugs, such as antithyroid drugs, sulfonamides, or lithium. If you consume one of these ingredients, your child may experience cretinism at birth.

Symptoms of cretinism in children

In children, the symptoms of cretinism that can be observed are:

Less weight
Stunted child growth
Exhausted and discouraged
Your appetite goes down
Abnormal bone growth
Mental retardation
Constipation
The skin and whites of the eyes turn yellow
Crying very rarely
The tongue is huge
Hoarseness
Swelling near the navel (umbilical hernia)
Dry and pale skin
Swelling of the neck from the thyroid gland

Cretinism occurs because the mother is deficient in iodine during pregnancy. So, mothers need to know the symptoms of iodine deficiency, namely:

Mumps
Easy fatigue
Slower heart rate
Cold

If pregnant women experience the conditions above, immediately contact the doctor for further treatment. This is done so that the risk of congenital hypothyroidism does not occur.

Treatment of children with cretinism

Children with cretinism should be monitored clinically. Here are some of them:

Screening

Based on the Guidelines for Cogenital Hypothyroid Screening of the Ministry of Health of the Republic of Indonesia in 2014, screening for children with cretinism includes:

Collection of blood specimens (ideal when the baby is 48-72 hours old)
In certain circumstances, blood draws can be tolerated approximately 24-48 hours when the mother is forcibly discharged
It is best if blood is not drawn within the first 24 hours after birth because TSH levels are very high. The reason is, this can give a high false positive result (false positive)
Blood samples dripped on filter paper and examined in the laboratory
Results can be obtained within one week

Clinical parameters

Quoting from Medscape, clinical parameters that must be monitored when a child experiences cretinism include:

Height growth
Weight gain
Development of children's abilities

In addition, children also need to do laboratory tests that are carried out 4-6 weeks after the first examination. Then it is repeated every 1-3 months during the first year and 2-4 months during the second and third years.

In children aged 3 years and over, the measurement interval is increased, depending on the child's abilities. During this time, there may be a change in the dosage of the drug, so the checkup should be more frequent.

Developmental and psychoneurological evaluation of the child

After carrying out clinical parameters, the next treatment is developmental and psychoneurological evaluation in children with cretinism.

This evaluation is especially important for children whose treatment is delayed or insufficient. Babies diagnosed early as having signs of congenital hypothyroidism are also at risk for developmental problems.

Evaluation is not necessary if the child has an anatomical thyroid abnormality when diagnosed by a doctor. If treatment for hypothyroidism in a 3 year old child has been carried out and the condition is still the same, the medical examination will be carried out for life.

Prevention of cretinism

Congenital hypothyroidism is usually seen in developing countries where iodine deficiency is common. Pregnant women are advised to consume 220 micrograms of iodine every day.

The American Thyroid Association recommends pregnant and lactating women take an additional supplement containing 150 micrograms of iodine per day.