Myxedema as Presenting Feature of Profound Primary Hypothyroidism in a Toddler

    Rasha Alradadi, Erica A. Eugster
    Studysummary This case report describes a rare and atypical presentation of primary hypothyroidism with myxedema in a two-year-old boy, highlighting the importance of recognizing unusual symptoms for timely treatment. Our plain-language summary of this paper — not a Tressless recommendation.
    This case study reported an unusual presentation of primary hypothyroidism in a 2-year-old boy, characterized by myxedema, pericardial effusions, and severe biochemical hypothyroidism, despite negative thyroid antibodies. The child, who had a history of lissencephaly and developmental delay, exhibited symptoms such as non-pitting edema and a sallow complexion, but lacked typical signs like cold intolerance or hair loss. His thyroid function tests showed an elevated TSH of 562 mcu/ml and a low FT4 of 0.3 ng/dl. Treatment with levothyroxine was initiated. The study highlighted the importance of recognizing atypical presentations of hypothyroidism in young children to ensure timely treatment and better neurocognitive outcomes.
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