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Growth and development in a child with resistance to thyroid hormone and ectopic thyroid gland

Natasha Heather1, Kate Hall, Katherine Neas

  • 1Department of Paediatrics, Capital and Coast District Health Board, Wellington, New Zealand.

Pediatrics
|February 8, 2012
PubMed

Insights

This study presents a rare case of thyroid hormone resistance combined with thyroid gland ectopy in a child with developmental delay. Persistent high thyrotropin levels suggest resistance to thyroid hormone may be an overlooked diagnosis.

Area of Science:

  • Endocrinology
  • Genetics
  • Pediatrics

Background:

  • Resistance to thyroid hormone (RTH) is a rare endocrine disorder.
  • Thyroid dysgenesis, including thyroid gland ectopy, is a known cause of congenital hypothyroidism.
  • Association between RTH and thyroid dysgenesis is uncommon.

Observation:

  • A 2-year-old patient presented with developmental delay, dysmorphic features, and elevated thyroxine and thyrotropin levels.
  • The patient had both thyroid gland ectopy and resistance to thyroid hormone.
  • This dual condition implies a reduced capacity for both thyroid hormone production and response.

Findings:

  • Thyroxine therapy was initiated to manage the condition.
  • The study documented the patient's response to thyroxine, focusing on growth and developmental progress.
  • Persistent elevation of thyrotropin was observed despite treatment.

Implications:

  • Persistent thyrotropin elevation is common in congenital hypothyroidism treatment.
  • Resistance to thyroid hormone should be considered in cases with persistently elevated thyrotropin.
  • This case highlights the importance of considering combined RTH and thyroid dysgenesis in pediatric patients.

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