- Given clinical features suggets the diagnosis of congenital hypothyroidism which can be caused d/t defect in thyroid. Hence option 4 is the answer. Cretinism: - Cretinism denotes physical & mental insufficiency secondary to congenital hypothyroidism. - Cretinism may be endemic, sporadic or familial & is twice as frequent in girls as in boys. - Iodination of salt has reduced incidence of cretinism in the United States and other countries. - The most common cause of neonatal hypothyroidism today is agenesis of thyroid, which occurs at rate of 1 in 4,000 newborns. - Symptoms of congenital hypothyroidism appear in early weeks of life and include sluggishness a large abdomen often with umbilical herniation impaired development of skeletal & central nervous system severe mental retardation protruding tongue low body temperature refractory anemia. stunted growth & characteristic facies - If thyroid hormone replacement therapy is not promptly provided, this results in mentally retarded dwarfs.