{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:28:16Z","timestamp":1768004896445,"version":"3.49.0"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>In children, hypothyroidism usually presents non-specific symptoms; symptoms can emerge gradually, compromising a timely diagnosis. We report the case of a 13-year-old male, who was admitted to the hospital due to swelling of the torso and neck. Besides these symptoms, the child was healthy, except for a significant growth delay. Ultrasound evaluation and blood tests led to the diagnosis of myxedema secondary to severe hypothyroidism, which was due to autoimmune thyroiditis. Further investigations revealed pericardial effusion and pituitary hyperplasia, with hyper-prolactinemia. Treatment with levothyroxine led to edema regression and clinical, hemato-chemical and radiological improvement. After 6 months, growth velocity increased, although the recovery of growth already lost was not guaranteed. Brain MRI showed regression of pituitary hyperplasia. The diagnostic delay in this case was probably due to the patient\u2019s apparent good health, and the underestimation of growth restriction. This report underlines the importance of growth monitoring in adolescence, a critical period for identifying endocrine conditions; if undiagnosed, these conditions can lead to serious complications, such as myxedema in hypothyroidism, with potential effects beyond growth on multiple organs.<\/jats:p>","DOI":"10.3390\/children10040614","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:31:05Z","timestamp":1679632265000},"page":"614","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Myxedema Due to Autoimmune Hypothyroidism: A Rare Complication of a Common Disorder"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6525-5672","authenticated-orcid":false,"given":"Elisa","family":"Bonino","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"},{"name":"Postgraduate School of Pediatrics, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Matarazzo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Buganza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerdi","family":"Tuli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Munarin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"},{"name":"Postgraduate School of Pediatrics, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Bondone","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"de Sanctis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Citt\u00e0 della Salute e della Scienza, 10126 Torino, Italy"},{"name":"Department of Public Health and Pediatric Sciences, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1097\/MOP.0b013e3283481ad4","article-title":"Supraclavicular swelling in hypothyroidism","volume":"23","author":"Clements","year":"2011","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/MOP.0b013e328355a31b","article-title":"Dermatologic manifestations of endocrine disorders","volume":"24","author":"Quatrano","year":"2012","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/jpc.14339","article-title":"Myxoedema coma in a 2-year-old girl with untreated congenital hypothyroidism: Case report and literature review","volume":"55","author":"Wankanit","year":"2019","journal-title":"J. Paediatr. Child Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1136\/adc.41.219.454","article-title":"Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I","volume":"41","author":"Tanner","year":"1966","journal-title":"Arch. Dis. Child"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1136\/adc.41.220.613","article-title":"Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II","volume":"41","author":"Tanner","year":"1966","journal-title":"Arch. Dis. Child"},{"key":"ref_6","first-page":"583","article-title":"Severe hypothyroidism due to autoimmune thyroiditis in a child: A one-year follow-up","volume":"13","author":"Vierucci","year":"2014","journal-title":"Hormones"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3329\/jbcps.v34i1.29167","article-title":"Precocious Puberty with Primary Hypothyroidism due to Autoimmune Thyroiditis","volume":"34","author":"Kasem","year":"2016","journal-title":"J. Bangladesh Coll. Physicians Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3126\/jnps.v39i3.23815","article-title":"Hypothyroidism Causing Precocious Puberty and Ovarian Torsion","volume":"39","author":"Kini","year":"2019","journal-title":"J. Nepal Paediatr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1515\/JPEM.2011.310","article-title":"Does clinical management impact height potential in children with severe acquired hypothyroidism?","volume":"24","author":"Nebesio","year":"2011","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1136\/adc.2007.134841","article-title":"Chronic autoimmune thyroiditis in children and adolescents: At presentation and during long-term follow-up","volume":"94","author":"Bulvik","year":"2009","journal-title":"Arch. Dis. Child."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1111\/j.1651-2227.2004.tb00860.x","article-title":"Thyroxine unmasks Addison\u2019s disease","volume":"93","author":"Shaikh","year":"2004","journal-title":"Acta Paediatr. Int. J. Paediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00381-020-05014-6","article-title":"Pituitary hyperplasia in childhood primary hypothyroidism: A review","volume":"37","author":"Sapkota","year":"2021","journal-title":"Child\u2019s Nerv. Syst."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1159\/000488467","article-title":"Myxedema Coma due to Hashimoto Thyroiditis: A Rare but Real Presentation of Failure to Thrive in Infancy","volume":"90","author":"Heksch","year":"2019","journal-title":"Horm. Res. Paediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.clinbiochem.2011.10.012","article-title":"Correlation of creatinine with TSH levels in overt hypothyroidism\u2014A requirement for monitoring of renal function in hypothyroid patients?","volume":"45","author":"Saini","year":"2012","journal-title":"Clin. Biochem."},{"key":"ref_15","first-page":"1165","article-title":"Pericardial Effusion in Severe Hypothyroidism in Children","volume":"23","author":"Deal","year":"2010","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"446","DOI":"10.24953\/turkjped.2016.04.019","article-title":"A case with atrophic autoimmune thyroiditis-related hypothyroidism causing multisystem involvement in early childhood","volume":"58","author":"Kurnaz","year":"2016","journal-title":"Turk. J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e12703","DOI":"10.1097\/MD.0000000000012703","article-title":"Primary hypothyroidism in a child leads to pituitary hyperplasia","volume":"97","author":"Cao","year":"2018","journal-title":"Medicine"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/4\/614\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:02:10Z","timestamp":1760122930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/4\/614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,24]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["children10040614"],"URL":"https:\/\/doi.org\/10.3390\/children10040614","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,24]]}}}