Cretinism

Abstract

CATHERINE is a four-year-old Greek refugee girl who speaks no English, and answers only to the Greek form of her name, Katina. When she was first admitted, Katina was a very irritable and belligerent little girl, scratching and biting anyone who came near her. Now, however, she is much better natured, becoming difficult only when a treatment or medication is particularly objectionable to her. Making a face or sticking her tongue out at one seems to be her way of showing affection. She still looks rather wild and untamed, and in spite of daily tub baths an animal-like odor persists. She is not over three feet in height and weighs thirty-two pounds. Her long, black hair has a slight tendency to curl and it hangs in her face despite all efforts to keep it properly combed. She has large, brown eyes set in a rather puffy little face. Katina's abdomen protrudes quite prominently, and she has a mild bowing of her lower legs, and stiff, but not large, knees. Her family consists of her father, who is in a veterans hospital for treatment of cancer, her mother who lives in another town, and two brothers, Koly and Constantine, who are also hospitalized for observation and treatment. The family was detained in Greece throughout the war, so Katina has existed on rations all her life. The family had been in the United States five months when Katina was admitted to Shodair Hospital. Until that time, they had been aided by the Red Cross and the welfare department in their community. When Katina was admitted, her general appearance suggested cretinism. There are two types of cretinism: athyreotic cretinism, in which the child does not lack thyroid before birth and in which the condition is not hereditary; and endemic cretinism, in which the child lacks thyroid