Endemic cretinism characteristics

Another example of a maternal condition that contributes to birth defects is low circulating iodine. Cretinism is one of the most profound, but completely preventable, syndromes of malformation known. Characteristic consequences of prenatal iodine deficiency include pervasive mental and physical retardation, deaf-mutism (due to primary malformation of the inner ear), lack of muscle tone with a spastic or rigid walk, and failure to attain a height at maturity of more than 1 m. Today, this condition (known as endemic cretinism) is most prevalent in impoverished areas of African and East Asian countries. Prior to implementation of a national program of iodized salt in the early part of the twentieth century, endemic cretinism was commonplace in Switzerland. After institution of iodized salt, deaf-mutism declined 50% within 8 years and no cretins have been born in that country since 1930. 

Thus we couldn t neglect the presence of the "subcretin" yet it is still not so easy to define the term definitely. Like the criteria of endemic cretinism, the subcretin should be associated with endemic goiter and severe iodine deficiency. The characteristics of the subcretin might include ... 

Examination of 40 neurologic endemic cretins born prior to the introduction of iodized oil (i.e. in the ID cohort) showed a gradation of severity in each of the three major types of impairments of neurologic endemic cretinism mental retardation, characteristic hearing loss and/or speech defect, and neuromuscular defect. Analysis of these data also showed a wide range and uniform distribution of overall degree of severity of impairment as measured by a composite index of severity. 

Endemic deafmutism represents the third degree of cretinous degeneration, which is characterized by this symptom, found together with imbecility, but not always associated with endocrine characteristics of cretinism (such as infantilism, myxedema). These cases leave the impression that in them the most severe alteration is the lesion to the nervous system (including defects of development of cortical centers). With the reservations inherent to any schematic proposal in Medicine, we could therefore summarize as follows ... 

Deficiency of T. e. can lead to characteristic deficiency symptoms or diseases, thus indicating the essential nature of these nutritional factors, e g. iodine is a component of the thyroid hormones and essential for thyroid function. Iodine deficiency is responsible for endemic goiter, and certain types of cretinism it can be avoided by addition of iodides to drinking water. Other T. e. are chromium, copper, fluoride, magnesium, manganese, nickel, vanadium, silicon, tin, selenium, zinc (see individual entries). 

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