Cretinism is a disease of the endocrine system, which is accompanied by a decrease in thyroid activity. This is a fairly common ailment, which, as a rule, manifests itself in childhood. So what are its first symptoms? What is dangerous violation of the synthesis of thyroid hormones? Are there effective treatments? The answers to these questions will be of interest to many readers.
Brief information about the structure and functions of the thyroid gland
Cretinism is a disease that is associated with a malfunction of the thyroid gland. Therefore, for starters, it will be useful to familiarize yourself with the general information about the work of this body.
The thyroid gland belongs to the endocrine glands. It is adjacent to the cartilage of the larynx, consists of a right and left lobe, as well as an isthmus connecting them. The main hormones of this gland are thyroxine and triiodothyronine, the synthesis of which occurs only if there is a sufficient amount of iodine. In addition, this body produces some other active substances, in particular calcitonin (the hormone responsible for the metabolism of calcium in the body).
The functioning of the thyroid gland also depends on the functioning of the hypothalamic-pituitary system in the brain. The pituitary gland releases thyroid-stimulating hormone, which activates the synthesis of thyroid hormones. And in the hypothalamus, substances are produced that control the pituitary gland.
With the participation of thyroid hormones, processes such as:
- metabolism, breakdown of adipose tissue, synthesis and breakdown of protein molecules;
- the formation of energy, which is necessary for the functioning of muscles and the nervous system;
- increased blood glucose;
- the work of the nervous and endocrine systems (thyroid hormones affect the work of other endocrine glands);
- transport of various substances to the cells.
Against the background of a decrease in the number of thyroid hormones, a disease called hypothyroidism develops. In turn, this ailment can lead to the development of cretinism, myxedema and other disorders of the endocrine system.
Hypothyroidism and its varieties
In fact, there are many classification systems for this disease. Most often, children suffer from cretinism, since this disease is congenital in them. On the other hand, it can also be acquired - to arise under the influence of certain factors.
Depending on the cause, several types of pathology are distinguished:
- primary hypothyroidism, which is associated with a malfunction of the thyroid gland;
- the secondary form of the disease, which occurs against the background of malfunctioning of the pituitary gland;
- tertiary hypothyroidism, in which there is a violation of normal regulation of the hypothalamus;
- violation of the sensitivity of target cells (in this situation, hormones are produced in sufficient quantities, but the cells are not sensitive to them).
Endemic cretinism, a phenomenon that occurs in residents of regions with insufficient iodine, is widely known.
Cretinism: reasons
Immediately it is worth saying that there are many factors that can lead to such a disease. As already mentioned, cretinism affects children who do not have enough thyroid hormones. And such a condition can be both congenital and acquired.
The causes of congenital hypothyroidism include:
- congenital underdevelopment or absence of a thyroid gland in a child;
- irradiation of a pregnant woman or taking medications that reduce gland function;
- maternal thyroid disease during pregnancy;
- genetic pathologies, as a result of which the capture of iodine by the thyroid tissue is impaired;
- hereditary immunity of the gland to the pituitary hormones;
- congenital diseases that disrupt the hypothalamic-pituitary system.
In turn, acquired forms of the disease can also occur under the influence of various factors:
- insufficient iodine in the diet of a pregnant woman or child;
- autoimmune thyroiditis;
- inflammatory processes in the thyroid gland;
- trauma or surgery on the thyroid gland;
- injuries, inflammation and surgical interventions on the brain, which are accompanied by damage to the hypothalamic-pituitary system;
- brain tumors.
Impaired cell sensitivity to thyroid hormones
A similar condition is congenital and is associated with some genetic characteristics, DNA structure disorders and chromosomes. In this disease, hormones are synthesized in normal amounts, but target cells are not sensitive to them. It is inherited from parents and practically does not respond to treatment.
Cretinism in children: what is the danger?
In fact, this ailment is extremely dangerous, because thyroid hormones in one way or another control the work of almost the entire body. So what are the consequences of the disease?
Cretinism affects the development of the brain, slowing it down. In particular, against the background of the disease, there is a violation of the development of nerve fibers, as well as a decrease in the total number of neurons and the formation of substances that inhibit the activity of the brain.
Naturally, a lack of thyroid hormones is due to other disorders in the body, in particular:
- slowdown of growth processes;
- muscle weakness;
- decrease in the formation of protein and energy compounds;
- violation of the processes of development of the skeleton;
- violation of blood formation processes;
- weakening of the immune system;
- malfunctions of the endocrine system, in particular the adrenal glands, gonads;
- violation of the normal functioning of the kidneys, liver, intestines, stomach;
- impaired skin function.
Naturally, if such problems arise in early childhood, then in the absence of treatment, a malfunction of almost all organ systems is observed.
The first signs of the disease in children
The only way to detect the disease in newborns is through a blood test for the hormone. Cretinism in the first 2-3 months of life is practically not manifested. However, the doctor may notice decreased appetite, difficulty in nasal breathing, frequent digestive problems, low heart rate and large fontanelles on the skull that do not overgrow for a long time.
As the baby grows, other more serious symptoms can be noticed. The child slowly gains weight, but looks plump, as it is prone to swelling. Sometimes there is severe swelling of the tongue. The size of the head is disproportionate, as the body lags behind in development. Such children, as a rule, have a wide nose bridge and narrow eyes, as well as a short and thick neck. You can notice some other disorders - the child is constantly sleepy, lethargic, unsociable. With age, you may notice a delay in mental development.
Symptoms of cretinism in adult patients
If untreated, the symptoms only worsen with age. People suffering from cretinism have very characteristic physical signs, in particular short stature, disproportionality of body parts. Constant swelling, clumsiness due to body structure, clubfoot, impaired mobility in various joints are also characteristic. There are also special facial features, in particular a high forehead, large lips, wide cheekbones, a constantly protruding tongue, protruding ears.
Almost all patients with a similar diagnosis suffer from some degree of mental retardation. Various hearing and speech impairments are also observed, sometimes up to deafness. Since the function of the gonads is reduced, infertility is possible. In addition, such people are sluggish, unsociable, lethargic and suffer from various mental disorders.
Modern diagnostic methods
If you suspect, you should immediately consult a doctor. Only a specialist knows what hypothyroidism is, the symptoms and treatment of which we are discussing today. To make an accurate diagnosis, simply examining the endocrinologist is not enough.
First, blood tests are performed for the content of thyroid hormones and the pituitary gland. By the way, some patients may develop the so-called temporary hypothyroidism, so the tests are repeated, after some time. In many clinics, blood is taken from newborns for preventive studies.
In the future, an ultrasound examination of the thyroid gland is also carried out, and if necessary, dopplerography and duplex scanning. These tests allow you to determine the size of the gland, the presence of enlargements, changes, neoplasms in the tissues of the thyroid gland, as well as the state of blood flow.
X-ray of the bones is also shown to children, since in children with this disease, ossification of the skeleton is slow. If necessary, the patient is also examined by a therapist or pediatrician, neurologist, orthopedist, psychiatrist - doctors help to identify the presence of complications and correctly draw up a treatment regimen.
Methods for treating the disease
Only a doctor knows what hypothyroidism is (symptoms and treatment of this disease, possible complications - all these points should be discussed with a professional), and only he can help you. Therefore, in no case should you neglect the advice of a specialist.
As a rule, patients are prescribed replacement therapy - they take hormonal drugs that make up for the deficiency of the natural thyroid hormones. In particular, the drug “L-thyroxine" is considered quite effective. In addition, vitamin complexes, nootropic drugs (Cerebril, Piracetam, Nootropil), as well as drugs to improve the functions, protection and nutrition of nerve tissues (Lipocerebrin, Pantogam, “ Encephabol ").
An important component of treatment is a proper diet, which will provide a sufficient amount of iodine. Depending on the condition of the patient, you may need the help of a neurologist or psychiatrist. In the future, the child must constantly undergo medical examinations and take tests, according to the results of which the doctor will be able to adjust the treatment regimen.
What are the prognoses for patients?
Cretinism is an extremely dangerous disease, as it can even lead to disability. Nevertheless, most often with early diagnosis and proper treatment, the patient manages to help. Normalization of the thyroid gland and pituitary gland leads to the elimination of metabolic disorders.
Nevertheless, far from all cases of complications can be avoided. For example, when therapy is started late, brain damage remains. And some genetic diseases are difficult even to symptomatic treatment.
Are there effective prevention methods?
It is worth noting that cretinism is an extremely serious disease that can in no way be ignored. With early detection and timely competent treatment, a lot of complications can be avoided. It is clear that many people are interested in the question of whether it is possible to prevent the development of the disease.
There are some simple rules that experts recommend following. For example, in areas where this ailment is common, general prevention should be carried out, in particular, to monitor the sufficient content of iodine in food.
Since cretinism affects children who do not have enough thyroid hormones, it is extremely important to pay attention to this point even at the stage of pregnancy planning. For example, parents are advised to take tests and undergo some tests for metabolic disorders and certain genetic diseases. In addition, a pregnant woman should carefully monitor the amount of iodine consumed. It is also very important to conduct screening tests immediately after the birth of the child, because the sooner the disease is detected, the higher the likelihood of a successful treatment before serious complications occur.