RESUMEN
Drug-induced liver injury (DILI) is an unwarranted problem and has been a scourge in the treatment of tuberculosis (TB) infection in general and children in particular. Usually, when the Antituberculosis treatment (ATT) regime is temporarily interrupted and modified, DILI subsides, and the whole treatment can be completed under supervision. We report a case of ATT-induced DILI not improving despite modification in the ATT regime, which ultimately led to the revealing of a yet unreported constellation of syndromes that included Wilson Disease, 46 XX gonadal dysgenesis, and Mayer Rokitansky Kuster Hauser (MRKH) Syndrome.
RESUMEN
OBJECTIVE: In the coronavirus disease 2019 (COVID-19) pandemic, a spectrum of sequelae affecting different organs has been reported. Of these, the ones affecting the thyroid gland have been reported, especially in the adults. CASE REPORT: We present previously healthy twin adolescents with no history of thyroid disease, presenting with signs and symptoms of hypothyroidism after recovery from mild COVID-19 infection. Their investigations were consistent with auto-immune thyroiditis with primary hypothyroidism, showing markedly elevated thyroid-stimulating hormone (TSH), suppressed FT4 levels, positive anti-thyroid peroxidase antibody and anti-thyroglobulin antibody titres. They were treated accordingly and showed quick clinical improvement in symptoms. CONCLUSIONS: This case report demonstrates that COVID-19 infection can be temporally associated with primary hypothyroidism in genetically predisposed children adding more to the growing list of sequelae especially in children.