Unmasking of childhood hypothyroidism by disseminated xanthomas.
Pediatrics
; 108(5): E96, 2001 Nov.
Article
in En
| MEDLINE
| ID: mdl-11694680
ABSTRACT
Secondary hyperlipidemia is a common laboratory finding in children with nephrotic syndrome, diabetes mellitus, and hypothyroidism. However, clinical signs of hyperlipidemia are extremely rare in childhood. We report on an 11-year-old girl who presented with a disseminated yellow papulomatous rash on the lower limbs and yellow skin creases on the palms of her hands. Blood tests yielded an opaque serum with a triglyceride concentration of 820 mg/dL and cholesterol of 1050 mg/dL. Skin biopsy of one of the papules confirmed the diagnosis of xanthomas. Additional examinations revealed clinical (weight gain, diminished growth rate) and biochemical primary hypothyroidism (free T4 0.4 ng/L [normal 8-22 ng/L]; thyroid-stimulating hormone >200 mU/L) as a consequence of Hashimoto thyroiditis (thyroid peroxidase and thyroglobulin 4400 U/mL and >2000 U/mL, respectively; normal <60 U/mL). The patient was started on L-thyroxine, which led to a gradual decline of cholesterol and triglycerides to normal concentrations and a complete remission from the xanthomatous rash. For the first time, this case depicts disseminated xanthomas of the skin as the presenting complaint of severe hypothyroidism. hyperlipidemia, hypothyroidism, xanthoma.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thyroxine
/
Thyroiditis, Autoimmune
/
Xanthomatosis
Type of study:
Etiology_studies
Limits:
Child
/
Female
/
Humans
Language:
En
Journal:
Pediatrics
Year:
2001
Document type:
Article