Journal of Emergency Practice and Trauma

A 10-year-old girl with red eyes and hypothyroidism

Document Type : Case Report

Authors

Zahra Ataee 1
Saeed Shokoohi-rad 2
Saman Soleimanpour 3

1 Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences Mashhad, Iran

2 Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Antimicrobial Resistance Research Center, Mashhad University of Medical Science, Mashhad, Iran

https://doi.org/10.34172/jept.2022.17
Abstract
Objective: Hypothyroidism has many causes and manifestations in children. One of the causes is autoimmunity, which is known as autoimmune thyroiditis or Hashimoto thyroiditis. Pseudotumor cerebri is a rare manifestation of Hashimoto thyroiditis. Here we report a 10-year-old girl with asymptomatic papillary edema who was treated with levothyroxine and acetazolamide.
Case Presentation: A 10-year-old girl suffered from left eye trauma while playing volleyball and went to an ophthalmology center due to redness in the same eye. During the examination, they noticed a bilateral optic disc swelling without ocular inflammation and the other eye examination was within normal limits. Encephalopathy may rarely occur during autoimmune thyroiditis, which is known as Hashimoto encephalopathy, and it is stated that the autoimmune disorder is not related to the thyroid dysfunction characterized by the symptoms of decreased level of consciousness and seizures.
Conclusion: The diagnosis of hypothyroidism in children is usually made by examining the thyroid-stimulating hormone (TSH), and T4 in which TSH is elevated and T4 is decreased as in our patient.

Keywords

Hypothyroidism
thyroiditis
Pseudotumor cerebri
Subjects
1. Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH. Occurrence and natural history of chronic lymphocytic
thyroiditis in childhood. J Pediatr 1975; 86(5): 675-82. doi:10.1016/s0022-3476(75)80350-7.
2. de Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and
during long-term follow-up. Arch Dis Child 2009; 94(1): 33-7. doi: 10.1136/adc.2007.134841.
3. Özer G, Yüksel B, Kozanoǧlu M, Serbest M, Turgut Ç. Growth and development of 280 hypothyroidic patients at
diagnosis. Acta Paediatr Jpn 1995; 37:145.
4. Atchison JA, Lee PA, Albright AL. Reversible suprasellar pituitary mass secondary to hypothyroidism. Jama 1989;
262(22): 3175-7.
5. Rallison ML, Dobyns BM, Meikle AW, Bishop M, Lyon JL, Stevens W. Natural history of thyroid abnormalities:
prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. Am J Med 1991; 91(4): 363-
70. doi: 10.1016/0002-9343(91)90153-o.
6. Demirbilek H, Kandemir N, Gonc EN, Ozon A,Alikasifoglu A, Yordam N. Hashimoto’s thyroiditis in children and adolescents: a retrospective study on clinical, epidemiological and laboratory properties of the disease.J Pediatr Endocrinol Metab 2007; 20(11): 1199-205. doi:10.1515/jpem.2007.20.11.1199.
7. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T4, and
thyroid antibodies in the United States population (1988 to1994): National Health and Nutrition Examination Survey
(NHANES III). J Clin Endocrinol Metab 2002; 87(2): 489-99. doi: 10.1210/jcem.87.2.8182.
8. Alink J, de Vries TW. Unexplained seizures, confusion or hallucinations: think Hashimoto encephalopathy.
Acta Paediatr 2008; 97(4): 451-3. doi: 10.1111/j.1651-2227.2008.00686.x.
9. Patnaik SK, Upreti V, Dhull P. Steroid responsive encephalopathy associated with autoimmune thyroiditis
(SREAT) in childhood. J Pediatr Endocrinol Metab 2014; 27(7-8): 737-44. doi: 10.1515/jpem-2013-0435.s
Journal of Emergency Practice and Trauma
Volume 8, Issue 2
July 2022
Pages 166-169

  • Receive Date 02 April 2022
  • Revise Date 01 June 2022
  • Accept Date 19 June 2022

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