Cretinism, endemic China

Selenium deficiency has been associated with specific diseases in China and Africa Keshan and Kashin-Beck disease (KBD) in Tibet and China and myxedematous cretinism in Central Africa. Interestingly, in all these selenium-deficient areas iodine deficiency is also endemic. The specific impact of iodine deficiency on human health is described elsewhere in this book and will not be repeated here, with the exception of health conditions where the interaction of iodine and selenium may contribute to the pathogenesis of a specific disease. This chapter will deal with diseases where both iodine and selenium deficiency play a role in disease causation and particularly with KBD. 

Li, J.Q. (1980). Endemic Goitre and Endemic Cretinism Scientific Conference Proceeding, Huixian, Xinxiang, Henan, China, p. 31. 

X.Y. Zhu, Endemic goiter and cretinism in China with special reference to changes of iodine metabolism and pituitary-thyroid function two years after iodine prophylaxis in Gui-Zhou, "Current problems in thyroid research , N. Ui, K. Torizuka, S. Nagataki and K. Hiyai eds., Excerpta Medica Publ., Amsterdam (1983), pp. 13-18. 

Guinea. The most detailed account of the neurology of endemic cretinism in recent times is provided by DeLong (4) on endemias in Zaire, Ecuador and China. 

Recently a series of non-verbal tests has been developed. Dr. Collin measured the intelligence of some school children in an endemic area in China using the Hiskey-Nebraska Test to avoid the language interference. Dr. DeLong and Dr. Lu L. had measured the intelligence of some cretin patients using the Beery test of visuomotor integration which has been considered free of cultural interference. 

Chu), The present status of endemic goitre and endemic cretinism in China, Food and Nutri. Bui. 4,4 13 (1981). 

ELECTROPHYSIOLOGICAL STUDIES IN ENDEMIC CRETINISM IN QINGHAI PROVINCE, PEOPLE S REPUBLIC OF CHINA... 

There have been few attempts to perform systematic electrophysiological studies in endemic cretinism. Somatosensory evoked potentials and brainstem auditory evoked responses (BAERs) have been reported in congenital hypothyroidism and acquired hypothyroidism. We report the results of electrophysiological studies on 46 cretins from a predominantly myxoedematous endemia in China, where nevertheless, all forms of cretinism are represented. 

Another major effect of fetal iodine deficiency is the condition of endemic cretinism. This condition, which occurs with an iodine intake of below 25 ug per day in contrast to a normal intake of 100-150 ug per day, is still widely prevalent, affecting for example up to 10 per cent of the populations living in severely iodine deficient areas in India, Indonesia and China. In its most common form, it is characterised by mental deficiency, deaf mutism and spastic diplegia, which is referred to as the "nervous" or neurological type in contrast to the less common "myxedematous" type characterised by hypothyroidism with dwarfism. 

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