CONGENITAL GOITRE Congenital goitre calls for special dis cussion. It is not of very rare occurrence, and consists of a transient, uniform conges tion of the entire thyroid gland, often enough, however, of congenital hyperplasia with in creased and enlarged follicles and cyst forma tion.
In 643 goitre eases in childhood, Demme found fifty-three affected congenitally; in one case the thyroid weighed as much as 102 Gm. as against 2 to 3 Gm. in the newborn. The following cases are often cited: Beraud and Danyau: goitre weighing 46 Gm. in a fetus five and one-half months old; Hecker: 46 Gm. in a new-born child; furthermore the cases of Virchow, llondini, Friedrich. Even dystocia has been reported owing to goitre iflubbauer, Houel). (Fig. 120.) hypertrophic thymus is also frequently observed in congenital goitre as well as in acquired goitre in older children and adults.
Contrary to the ordinary form, congenital goitre presents a uniform change of the entire gland, comprising the entire anterior cervical region from the maxillary bone to the sternum, which, however, spontaneously decreases, and seldom develops into a per manent and extensive growth.
A few cases have been reported in which there was grave asphyxia at birth or soon after, tracheal stenosis with secondary bronchopneumonia and dyspncea, pronounced cyanosis owing to compression of the large cervical vessels, and rapid death.
Aside from heredity which plays an important part in goitre, delivery in facial position or abnormal traction on the thyroid vessels (Virchow) have been mentioned as etiological factors.
The treatment is the same as in goitre of older children. Iodine therapy through the intermediary of the mother's milk has been recom mended by Mosso and Cathala, also thyroid tablets have been given to the mother with good results. Iodipin and potassium iodide are like wise to be considered.