{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:21:20Z","timestamp":1765423280246},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2021-0391_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Myxedema crisis, a fatal complication of severe hypothyroidism, is extremely rare in children and treatment guidelines are lacking. Since availability of intravenous levothyroxine is limited in resource poor settings, myxedema crisis can be treated with oral levothyroxine and\/or oral liothyronine (if necessary), in the absence of cardiac risk factors, thus hastening the recovery and significantly decreasing the associated morbidity and mortality. In the background of untreated hypothyroidism, a possible association of ovarian hyperstimulation syndrome (OHSS) and reactive pituitary hyperplasia should be kept in mind, thus preventing unnecessary interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2021-0391_abs_003\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>A 13-year-old girl child with Down syndrome, presented with myxedema crisis, as initial presentation of untreated hypothyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2021-0391_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Annual screening, timely diagnosis of hypothyroidism, and early initiation of thyroid hormone supplementation will prevent associated physical and neurocognitive morbidity in children, especially those with Down syndrome. Importance of oral liothyronine supplementation in myxedema crisis, has been highlighted in this case report.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2021-0391","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T20:13:45Z","timestamp":1632255225000},"page":"267-271","source":"Crossref","is-referenced-by-count":1,"title":["Myxedema crisis and ovarian hyperstimulation in a child with Down syndrome"],"prefix":"10.1515","volume":"35","author":[{"given":"Maria Susan","family":"Abraham","sequence":"first","affiliation":[{"name":"Department of Family Medicine , Dr. Kamakshi Memorial Hospital , Chennai , Tamil Nadu , 600100 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geethalakshmi","family":"Sampathkumar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , Dr. Kamakshi Memorial Hospital , Chennai , Tamil Nadu , 600100 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeshwari","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Dr. Kamakshi Memorial Hospital , Chennai , Tamil Nadu , 600100 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prahada","family":"Jagannathan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Dr. Kamakshi Memorial Hospital , Chennai , Tamil Nadu , 600100 , India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"2022020803263079398_j_jpem-2021-0391_ref_001","doi-asserted-by":"crossref","unstructured":"Divecha, CA, Tullu, MS, Deshmukh, CT, Karande, S. Myxedema coma in a pediatric patient with Down syndrome. J Pediatr Intensive Care 2020;9:70\u20133. https:\/\/doi.org\/10.1055\/s-0039-1698812.","DOI":"10.1055\/s-0039-1698812"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_002","doi-asserted-by":"crossref","unstructured":"Mathew, V, Misgar, RA, Ghosh, S, Mukhopadhyay, P, Roychowdhury, P, Pandit, K, et al.. Myxedema coma: a new look into an old crisis. J Thyroid Res 2011;2011:493462. https:\/\/doi.org\/10.4061\/2011\/493462.","DOI":"10.4061\/2011\/493462"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_003","doi-asserted-by":"crossref","unstructured":"Root, JM, Vargas, M, Garibaldi, LR, Saladino, RA. Pediatric patient with altered mental status and hypoxemia: case report. Pediatr Emerg Care 2017;33:486\u20138. https:\/\/doi.org\/10.1097\/pec.0000000000000722.","DOI":"10.1097\/PEC.0000000000000722"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_004","unstructured":"Sim\u015fek, E, Sim\u015fek, T, Sava\u015f-Erdeve, S, Erdo\u011fmu\u015f, B, D\u00f6\u015fo\u011flu, M. Pituitary hyperplasia mimicking pituitary macroadenoma in two adolescent patients with long-standing primary hypothyroidism: case reports and review of literature. Turk J Pediatr 2009;51:624\u201330."},{"key":"2022020803263079398_j_jpem-2021-0391_ref_005","unstructured":"Schutt-Aine, JC. Hypothyroid myxedema and hyponatremia in an eight-year-old child: a case report. J Natl Med Assoc 1980;72:705\u20138."},{"key":"2022020803263079398_j_jpem-2021-0391_ref_006","doi-asserted-by":"crossref","unstructured":"Thompson, MD, Henry, RK. Myxedema coma secondary to central hypothyroidism: a rare but real cause of altered mental\u00a0status in pediatrics. Horm Res Paediatr 2017;87:350\u20133. https:\/\/doi.org\/10.1159\/000449223.","DOI":"10.1159\/000449223"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_007","doi-asserted-by":"crossref","unstructured":"Zhu, Y, Qiu, W, Deng, M, Zhu, X. Myxedema coma: a case report of pediatric emergency care. Medicine (Baltimore) 2017;96:e6952. https:\/\/doi.org\/10.1097\/md.0000000000006952.","DOI":"10.1097\/MD.0000000000006952"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_008","doi-asserted-by":"crossref","unstructured":"Heksch, RA, Henry, RK. Myxedema coma due to hashimoto thyroiditis: a rare but real presentation of failure to thrive in infancy. Horm Res Paediatr 2018;90:332\u20136. https:\/\/doi.org\/10.1159\/000488467.","DOI":"10.1159\/000488467"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_009","doi-asserted-by":"crossref","unstructured":"Wankanit, S, Mahachoklertwattana, P, Anantasit, N, Katanyuwong, P, Poomthavorn, P. Myxoedema coma in a 2-year-old girl with untreated congenital hypothyroidism: case report and literature review. J Paediatr Child Health 2019;55:707\u201310. https:\/\/doi.org\/10.1111\/jpc.14339.","DOI":"10.1111\/jpc.14339"},{"key":"2022020803263079398_j_jpem-2021-0391_ref_010","doi-asserted-by":"crossref","unstructured":"Janson, A, H\u00e4llstr\u00f6m, C, Iversen, M, Finder, M, Elimam, A, Nerg\u00e5rdh, R. Initial low-dose oral levothyroxine in a child with Down syndrome, myxedema, and cardiogenic shock. Clin Case Rep 2019;7:1291\u20136. https:\/\/doi.org\/10.1002\/ccr3.2169.","DOI":"10.1002\/ccr3.2169"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0391\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0391\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T03:27:06Z","timestamp":1644290826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0391\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,22]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,10,1]]},"published-print":{"date-parts":[[2022,2,23]]}},"alternative-id":["10.1515\/jpem-2021-0391"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2021-0391","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,22]]}}}