Enlargement of the sella turcica secondary to juvenile myxedema

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A FREQUENT presenting sign of hypothyroidism in children is short stature. Failure to grow may be a manifestation of hypothyroidism due to pituitary malfunction or to primary thyroid failure. This differentiation is of prime importance before appropriate therapy can be initiated. This paper presents a case of enlargement of the sella turcica in a child of short stature. After the diagnosis of primary juvenile myxedema was made, thyroid replacement therapy was begun and the size of the sella turcica decreased to normal.

Report of a case

A 9¾-year-old girl was first examined at the Cleveland Clinic in March 1966 because of short stature. She weighed between 7 and 8 lb. at birth. Weight and height values were not available for the years before 1966, but she had been short for several years and had worn the same size dress for three years prior to 1966. There was no family history of exceptionally short stature.

She had sat alone at eight months and had walked at 18 months. After that her development had been slower than average. She was described as a quiet and shy child with slow movements. Despite increased emotional lability, she was an A student. Since infancy she had had a problem with constipation, which had been controlled with diet. Her skin had always been quite dry. Her medical history and review of systems were otherwise non-contributory.

On physical examination the blood pressure was 80/60 mm Hg, height 46 in., weight 56 lb., and temperature 98.2F. The results of . . .



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