Onset of acquired autoimmune hypothyroidism in infancy: a presentation of delayed gross-motor development and rhabdomyolysis |
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Authors: | Daniel F Gunther Harvey K Chiu Thomas E Numrych Gad B Kletter |
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Institution: | (1) Division of Pediatric Endocrinology, Children’s Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, WA 98105, USA;(2) Sand Point Pediatrics-Virginia Mason, Seattle, WA, USA |
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Abstract: | We report the case of a 23-month-old girl who presented with poor growth and delayed attainment of gross-motor milestones.
Elevated creatine phosphokinase (CPK) indicated rhabdomyolysis, ultimately attributed to severe, acquired autoimmune hypothyroidism.
Growth data and bone-age suggest the onset of hypothyroidism occurred at or before 12 months of age. Acquired hypothyroidism
is rare before age 3 years, and rhabdomyolysis due to hypothyroidism has not previously been reported as a cause of delayed
gross-motor development in toddlerhood. Despite the early onset of hypothyroidism, cognitive function appeared to be unaffected.
Adequate thyroid hormone replacement quickly normalized the CPK in our patient, and gross motor development rapidly improved.
Although rare, rhabdomyolysis secondary to hypothyroidism should be in the differential diagnosis of delayed gross-motor development
in infancy and toddlerhood. |
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Keywords: | Thyroid Thyroiditis Infant Rhabdomyolysis Creatine phosphokinase Motor development Developmental milestones |
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