A 5-year-old girl with 8 months of chronological age who complains of hypercholesterolemia (non-familial) with visceral pericardium deposits compatible with fat, observed by ultrasonography, with no response after 4 months of treatment with cholesterol lowering.
At the beginning of the treatment she had TC 410 mg/dl, LDL-C 290 mg/dl; 4 months after treatment TC 359 mg/dl and LDL-C 290 mg/dl. The child had no history of cold appetite until two years ago, constipation.
He did not play any kind of environmental interest.
She was treated with iron for anemia and referred to psychotherapy for supposed childhood depression.
Physical examination at the time of referral showed a thin child, weighing 14.1 kg (-2.5 SD), height 100 cm (-2.2 SD), prepubertal, no dysmorphic, palpable heart sounds with non-palpable skin.
Bone age of 2 years and 6 months The echocardiogram showed thickening of the visceral pericardium, detachment of the parietal pericardium up to 1 cm, echogenic "deposits" with subacute visceral fat mapping or pericarditis compatible.
1.
Based on the findings of clinical signs of hypometabolism, a clear linear growth deceleration 3.4, bone voiding age, even non-palpable thyroid gland, hypothyroidism was diagnosed.
It should be noted that between 5.25 and 5.7 years had lost 1,200 kg and stopped linear growth.
1.
The laboratory confirmed the diagnosis of severe hypothyroidism due to autoimmune thyroid disease: TSH >54 uUI/ml (VN <4.2), T3: 0.40 ng/ml (VN: 0.861-1.97) thyroglobulin (T4:
Thyroid ultrasound showed a gland of homogeneous structure and decreased size, without focal lesions: right lobe 0.56 x 1.42 x 0.64 cm; left gland 0.95 x 1.87 x 0.57 cm, volume of 0.8 ml per volume
