Primary hypothyroidism with pericardial tamponade

We report a rare case of pericardial effusion and tamponade in a 10-yr-old child with undiagnosed primary hypothyroidism, who presented to us with delayed milestones, anasarca for 7 mth and respiratory distress for 20 days. The child recovered with ultrasound guided pericardial tap and thyroxine replacement therapy.