Thyroidal Function in a Goiter Endemic IV. Hypothyroidism and Endemic Cretinism

Thirty-five patients with retarded bodily growth, retarded mental development and typical cretinoid appearance have been studied in the endemic goiter area of the Uele (Congo). These patients, who may thus be called endemic cretins, exhibit clinical, electrocardiographic, radiologic and biological evidence of present hypothyroidism. The severity of the stigmata of cretinism (nanism, imbecility) has been related to the severity of hypothyroidism, as evidenced by retardation of bone maturation, abdominal swelling, umbilical hernia, myxedema and atrophic genitalia. As experimental evidence shows that a clinical picture similar to cretinism can be produced in animals by hypothyroidism, it is concluded that Uele endemic cretinism is mainly due to hypothyroidism.