A child from a known goiter-endemic Himalayan district presents with deaf-mutism, squint, and spastic diplegia with intellectual disability. Thyroid function tests show borderline low free T4 with normal TSH. This condition results primarily from which deficiency occurring at a specific time?
- A Maternal iron deficiency during third trimester
- B Postnatal iodine deficiency in infancy
- C Maternal iodine deficiency during early pregnancy ✓
- D Neonatal selenium deficiency
Correct answer: C. Maternal iodine deficiency during early pregnancy
Explanation
Neurological endemic cretinism results from maternal iodine deficiency and hypothyroxinemia during the first trimester, causing irreversible damage to fetal brain development. It manifests as deaf-mutism, squint, spastic diplegia, and intellectual disability, often with minimal thyroid hormone abnormality after birth because the child may receive some iodine postnatally. Postnatal deficiency causes reversible hypothyroidism, not this fixed neurological syndrome.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.