Cretinism is a congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature, mental retardation, dystrophy of the bones, and a low basal metabolism. A male child about 5 months in age was brought into the child’s family doctors office with the complaint of obstipation (a severe form of constipation). Mother experience a normal pregnancy and child was birth weight was 6 ½ lbs. Mother was 25 and her first child and there was no consanguinity between parents. The child was being breastfeed and mother described child as “being a normal good baby”. Child seemed normal till about 4 ½ months of age when first signs of constipation were seen. As it is not uncommon for children who are breast feed to a bowl movement every few days, the mother did not seek medical attention until after home remedies did not have an effect and the child seem to worsen. Upon the doctor examination the child appeared to have typical features of cretinism course, scantly placed hair, pale, sallow (an unhealthy yellow color) complexion, heavy eyelids, thick nose and lips, and tongue protruding from the mouth. Child also had large supraclavicular pads of fat, a protuberant abdomen and a small umbilical hernia, extreme dry skin and had hypotonicity of the musculature ( was able to twist and bend limbs without any discomfort), the child was also not able to hold his head up by himself and had not smiled yet, but was otherwise with in normal limits for his age. Due to the expense and distance from the lab the doctor only ordered a blood Cholesterol test (which came back @ 600 mg. %) and x-ray which showed bone retardation in the wrist. The child was immediately started on dry thyroid tablets and has since regained a normal growth pattern and has reached developmental milestones, sitting without support at 8 months, standing at 1 year and walking The child also appears
Cretinism is a congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature, mental retardation, dystrophy of the bones, and a low basal metabolism. A male child about 5 months in age was brought into the child’s family doctors office with the complaint of obstipation (a severe form of constipation). Mother experience a normal pregnancy and child was birth weight was 6 ½ lbs. Mother was 25 and her first child and there was no consanguinity between parents. The child was being breastfeed and mother described child as “being a normal good baby”. Child seemed normal till about 4 ½ months of age when first signs of constipation were seen. As it is not uncommon for children who are breast feed to a bowl movement every few days, the mother did not seek medical attention until after home remedies did not have an effect and the child seem to worsen. Upon the doctor examination the child appeared to have typical features of cretinism course, scantly placed hair, pale, sallow (an unhealthy yellow color) complexion, heavy eyelids, thick nose and lips, and tongue protruding from the mouth. Child also had large supraclavicular pads of fat, a protuberant abdomen and a small umbilical hernia, extreme dry skin and had hypotonicity of the musculature ( was able to twist and bend limbs without any discomfort), the child was also not able to hold his head up by himself and had not smiled yet, but was otherwise with in normal limits for his age. Due to the expense and distance from the lab the doctor only ordered a blood Cholesterol test (which came back @ 600 mg. %) and x-ray which showed bone retardation in the wrist. The child was immediately started on dry thyroid tablets and has since regained a normal growth pattern and has reached developmental milestones, sitting without support at 8 months, standing at 1 year and walking The child also appears