Hypothyroidism

Hypothyroidism is presented in two modes:cretinism(during infancy and myxoedema after puberty).

Causes of CRETINISM:
-congenital absence or hypoplasia of thyroid gland
-congenital defect in the enzymes converting iodide into nascent iodine or entering into formation of di-ioothyroisine
-endemic cretinism(due to iodine deficiency)
-an amount use of antithyroid drugs or rasioactive iodine during pregnancy.

Characteristics:
1.General features:
Face:
-puffness of eye lids and depressed nasal bridge
-big lips and large protruding tongue
-delayed dentition and teeth are small
Hands:
-square sharped whit short tapering fingers
-dorsal pad of fat
Disproportionate dwarfsm(the height is more than the span).
Walking is delayed and the gait is waddling due to dysgenesis of the femur head and muscle weakness.
Subnormal body temperature.
2.Skin manifestation;
-dry,rough,scaly.cold skin
-hair is scanty,coarse and britte
-deposition of subcutaneus myxoedematous tissue,particularly on the dorsum of hands,face and suclavian region
3.Nervous Manifestations:
-mental retardation
-slow speaking and thinking and hoarse cry
4.Cardiovascular Manifestations:bradycardia and electrocardiogramma shows low voltage
5.Muscle weakness:together with constipation lead to pot belly abdomen and the umbelical hernia is common.

The treatment in case of hypothyroidism should be started before the elapse of the first year of life to prevent mental retardation.And after the medical prescription Thyroxin is started by 0,025mg/day and gradually increase up to 0.2 mg/day for life.