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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper describes the clinical, hormonal and radiologic profiles in 282 children evaluated for hypothyroidism. Short stature, mental retardation or puberal disturbances were often the presenting features in the older age group, whereas in the 1-5 years age group medical opinion was usually sought for symptomatology suggestive of thyroid hypofunction. Children in the 0-1 year group were suspected on the basis of psychomotor dysfunction. Skeletal immaturity was found in 93.0% of patients with overt hypothyroidism and in 36.6% cases with normal thyroid profiles but associated with malnutrition. High TSH levels were noted in 70.9% of the cases studied. 4.9% and 7.3% patients with normal TSH had low T3, and T4 levels respectively. FSH, testosterone and PRL levels were also affected in some patients with overt hypothyroidism. Therapeutic responses based on at least 1 year follow up were available in 170 cases. The results are discussed.
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PMID:Hypothyroidism in children/adolescents. Clinical and hormonal profiles. 263 58

Disorders caused by iodine deficiency continue to be a major health problem in many underdeveloped areas of the world. The most significant is the impaired mental and physical development which occurs as a result of iodine deprivation early in life. Individuals in affected communities show a spectrum of abnormalities which can be attributed to two interacting pathological processes. Fetal hypothyroidism in the first and early second trimester predominantly affects the developing nervous system causing deaf-mutism and mental retardation. If hypothyroidism occurs in the early postnatal period the main abnormalities are growth stunting and related somatic abnormalities. Subclinical deficits of intellectual and motor development may also be found in apparently normal individuals living in affected areas. Although dietary iodine deficiency is clearly the major aetiological factor in both endemic goitre and cretinism, cofactors such as goitrogens, other trace element deficiencies and immunological mechanisms may greatly modify the expression of these disorders. Iodine supplementation programmes form the basis of the public health strategy in combatting these disorders. Where the iodization of foodstuffs is not feasible, an alternative is the use of iodine containing oil which can be given orally or intramuscularly to provide a long-lasting supply of iodine.
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PMID:Endemic goitre and iodine deficiency disorders--aetiology, epidemiology and treatment. 306 26

Thirty-six chronically psychotic patients (nine men and 27 women, mean age 56.7 +/- S.D. 13.4 years) were found to have elevated thyroid stimulating hormone (TSH) levels during review of thyroid function screening tests of 1150 patients over a 15 month period in a 700 bed state mental hospital. This study population of 36 patients was more likely to be female and older than the general hospital population. The spectrum and frequency of psychiatric diagnoses included dementia (3); schizoaffective disorder (12); bipolar disorder (6); schizophrenic disorder (4); organic affective disorder (7); major depression (3); and mental retardation (1). Only nine of these 36 patients failed to receive the goitrogens lithium (LI), carbamazepine (CBZ) and/or phenytoin (PTN) and five of those nine patients had a history of thyroid disease. Sex did not predict age, thyroxine (T4) level, triiodothyronine (T3) uptake, or TSH. The distribution of psychiatric diagnoses were the same for both sexes. Expectedly, there was an inverse relationship between TSH and T4 and T3 uptake. Using T4 to separate grades 1 and 2 hypothyroidism revealed that six (17%) patients had grade 1 disease. Men were more likely to have a seizure disorder and receive LI, CBZ, and PTN. Women were more likely to have a history of thyroid disease. The goitrogenic effects of LI + CBZ seemed additive compared with patients receiving LI alone. While T4, T3 uptake, and LI levels were the same for the two groups, patients receiving LI + CBZ had higher TSH values (p = 0.028) than did patients receiving LI alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Grades 1 and 2 hypothyroidism in a state mental hospital: risk factors and clinical findings. 310 44

The screening of neonates for metabolic diseases is important in order to identify a population with or at risk for metabolic diseases. Early diagnosis can then be made, treatment instituted and physical and/or mental handicaps due to the disease can be prevented. The World Health Organization's screening criteria are helpful in selecting those diseases appropriate for screening. Usually a state-designated central laboratory performs the screening tests. All states screen for phenylketonuria (PKU) and hypothyroidism; in addition, 26 states screen for galactosemia, 20 for maple syrup urine disease and 19 for homocystinuria. The cost-benefit ratio for screening programs is excellent, varying from 1:13 to 1:20. The necessary follow-up of patients for diagnosis and treatment can be enhanced by maintaining a close liaison with the laboratory and providing adequate information to parents. As a result of instituting a screening program, the incidence of mental retardation due to PKU has been practically eliminated and new insights about metabolic diseases have been obtained. The rapid progress in technology may soon result in better and cheaper tests capable of identifying more diseases amenable to treatment.
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PMID:Neonatal screening for metabolic and endocrine diseases. 311 77

The authors report their experience in the systematic, co-ordinated and controlled neonatal screening in France: a coverage of approximately 100 per cent for several years, nearly 13 millions of tests for phenylketonuria and more than 7 millions for hypothyroidism, almost 850 phenylketonuric children and more than 1,600 patients with hypothyroidism, screened and taken care of. The frequency of phenylketonuria is estimated at 1 for 16,394 and the frequency of hypothyroidism at 1 for 4,041. They insist on the need for a strict investigation of false negatives and point out a few specific points on the care of affected children. Overall, the assessment of neonatal screening is positive since it has allowed 2,500 children, doomed to mental retardation, to have a normal growth.
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PMID:[Neonatal screening for phenylketonuria and hypothyroidism in France. A 12-year experience]. 317 78

Congenital hypothyroidism is the commonest endocrine disorder of childhood. Early thyroxine therapy will ameliorate or prevent the considerable physical and mental retardation that is the hallmark of infantile hypothyroidism, and evidence is presented that a neonatal screening programme for thyroid hormones will reveal evidence of primary thyroid hypofunction (1/4 500 births) in infants prior to clinical diagnosis.
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PMID:Congenital hypothyroidism. Clinicopathological aspects and biochemical screening. 701 10

Two consecutive short gut babies with a residual small intestinal length of 44 and 46 cm, respectively, were managed initially by total parenteral nutrition and oral feedings begun around the fifth week postoperatively. Uncontrollable diarrhea, malabsorption, and failure to thrive made the early management of these babies a difficult problem. The two infants developed clinical features of hypothyroidism at the age of 4 and 6 mo, respectively. Hypothyroxinemia was confirmed by repeated detection of low serum levels of T4. Hormonal treatment resulted in clinical recovery and normalized T4 values. Thyroid function has remained normal after discontinuation of treatment, underlining the transient nature of hypothyroidism. Early recognition and therapy of this previously unreported association is essential in order to prevent mental retardation.
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PMID:Transient hypothyroidism associated with short gut syndrome. 707 72

We report on a 12 1/2-year-old boy with bilateral testicular enlargement. After an extensive evaluation we eliminated precocious puberty, hypothyroidism, congenital adrenal hyperplasia, X-linked mental retardation and bilateral malignant testicular neoplasms from consideration. Diagnosis was benign macro-orchidism. The clinical and laboratory features of this condition are sufficiently distinct from the other causes of testicular enlargement to allow a diagnosis to be made without testicular biopsy or orchiectomy.
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PMID:Benign macro-orchidism in a pubescent boy. 721 69

This work reports the presence of endemic cretinism in a small district located inside an endemic goiter area in north-eastern Sicily, personally described. The study covers 19 mental defectives (11 females and 8 males, mean age 35.8 +/- 15.5 yr) selected on the basis of severe mental retardation recognized by the local doctors. No systematic survey for cretinism was carried out in the total population. Marked mental retardation was evident in all subjects. Nine of them exhibited clinical and biochemical signs of hypothyroidism (myxedematous cretins). The 10 others were clinically euthyroid and had deaf-mutism and/or pyramidal tract dysfunction (neurological cretinism). Familial aggregation of cretinism was also observed. In both myxedematous and neurological cretins and urinary iodine excretion was very low, but not significantly different from that recorded in the euthyroid controls of the same area. The data available do not clarify the pathogenesis of endemic cretinism in Sicily. However, the marked height retardation, the observation of delayed bone maturation and the severity of mental deficiency suggest that thyroid failure was present in early life. The presence of endemic cretinism today in Sicily constitutes a strong argument in favour of the immediate introduction of adequate iodine prophylaxis.
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PMID:Endemic cretinism in Sicily. 732 Apr 34

Thirty-nine children at 7 to 9 years of age with congenital hypothyroidism have been studied with respect to their intellectual, neurological and social functions. Their intellectual achievement as assessed by the WISC test, was significantly lower than in a reference population (mean IQ 88, range 50-113). In children who showed signs and symptoms of hypothyroidism during their first four weeks of life, there was a negative correlation between the age when therapy was started and intellectual development. No such correlation was found in children who showed signs and symptoms after the first four weeks of life. Nine children of 26 with signs of hypothyroidism in the neonatal period, were found to have neurological abnormalities consisting of fine and gross motor disturbances. The neurological abnormalities seriously affected daily life in only the two most severely mentally retarded. No correlation was found between the age when the therapy was started and neurological abnormalities. Three children attended special schools because of mental retardation and six attended normal schools but required additional teaching assistance for learning disabilities. Our results suggest that the risk of future intellectual handicaps may be reduced by early treatment in children with hypothyroidism presenting during the neonatal period.
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PMID:Congenital hypothyroidism in Sweden. Psychomotor development in patients detected by clinical signs and symptoms. 732 45


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