Author/Authors :
Anah, MU Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria , Ansa, VO Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria , Etiuma, AU Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria , Udoh, EE Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria , Ineji, EO Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria , Asindi, AA Departments of Paediatric - Medicine - Cardio-Thoracic Surgery - University of Calabar Teaching Hospital - Calabar, Nigeria
Abstract :
BACKGROUND: The complex of Down Syndromehypothyroidism-
pericardial effusion is largely unreported in
sub-Sahara.
OBJECTIVE: To present and highlight an unusual manifestation
of hypothyroidism.
METHODS: A 16-year-old girl with confirmed Down Syndrome
presented with complaints of generalised body swelling of eight
months’ duration. Her work-up consisted of full clinical and
laboratory evaluation including ECG and echocardiography.
RESULTS: The patient was diagnosed of Down’s Syndrome at
birth but was lost to follow-up after at eight years of age. Body
swelling was associated with clinical features of heart failure.
Echocardiography showed massive pericardial effusion. Serum
l-thyroxine was less than 0.5μg/dl and TSH >40iu/l. The heart
failure and menstrual irregularities responded to l-thyroxine
therapy.
CONCLUSION: This appears to be the first report of the
complex of Down syndrome, hypothyroidism and pericardial
effusion in a Nigerian child. Thyroid function test is therefore
recommended as a part of baseline investigation for Nigerian
children with Down syndrome as is the practice
Keywords :
Case report , L-thyroxine therapy , Down syndrome , Pericardial effusion , Hypothyroidism
