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35. What are the monosymptomatic presentations of juvenile hypothyroidism?

The monosymptomatic presentations of juvenile hypothyroidism include short

stature, delayed puberty, poor scholastic performance, precocious puberty (Van

Wyk–Grumbach syndrome), myopathy (Kocher–Debre–Semelaigne syn-

drome), limping gait (stippled epiphysis and slipped femoral epiphysis), head-

ache and visual fi eld defects (thyro-lactotrope hyperplasia), diffuse goiter and,

rarely, acute abdomen (huge multicystic ovaries and acute cholecystitis), and

pericardial effusion (Figs. 3.12 , 3.13 , and 3.14 ).

ab

Fig. 3.12 ( a ) Short stature in a 14-year-old boy with juvenile primary hypothyroidism. ( b )
Myxedematous features in the same child

3 Thyroid Disorders in Children