Cardiomyopathy and pseudopuberty in a girl with severe hypothyroidism due to autoimmune thyroiditis
We report a 12-year-old girl with long-standing severe hypothyroidism due to autoimmune thyroiditis. She presented with congestive heart failure as a result of dilated cardiomyopathy, multiple-valve regurgitation, and pericardial effusion. She also had severe short stature (-5 standard deviation) an...
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| Main Authors: | , , , |
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| Format: | Article |
| Published: |
2018
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| Subjects: | |
| Online Access: | https://repository.li.mahidol.ac.th/handle/123456789/25039 |
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| Institution: | Mahidol University |
| Summary: | We report a 12-year-old girl with long-standing severe hypothyroidism due to autoimmune thyroiditis. She presented with congestive heart failure as a result of dilated cardiomyopathy, multiple-valve regurgitation, and pericardial effusion. She also had severe short stature (-5 standard deviation) and profound retarded bone age (3 years). Despite severe growth retardation, she had breast development without galactorrhea. She had a prepubertal response to luteinizing hormone-releasing hormone. Multicystic ovaries were noted on pelvic sonography. Magnetic resonance imaging of the brain revealed pituitary hyperplasia. Treatment with l-thyroxine and digoxin was promptly initiated with a subsequent clinical improvement and near-normal thyroid function tests. Unfortunately, she developed digitalis intoxication at 6 weeks, and eventually expired. Thus, titrating the dose of digoxin and frequent monitoring of serum digoxin levels are essential to prevent digitalis intoxication in the hypothyroid patient. © 2007 Lippincott Williams & Wilkins, Inc. |
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