PUBERTAL HYPOTHYROIDISM. LACK OF GROWTH RESPONSE AFTER THYROID REPLACEMENT.

Abstract

Thyroidal failure at puberty produces a syndrome with clinical manifestations intermediate between those of cretinism and adult myxedema. In addition to the symptoms of generalized hypometabolism, there are disturbed gonadal maturation, growth failure, and mental retardation, in variable degrees, dependent on the time of onset and extent of thyroprivia. Although it is stated broadly in textbooks that thyroid hormone replacement will reverse all of the hypothyroid changes, there are few reports which document the effect of therapy on growth. The observation of a patient with pubertal hypothyroidism, growth failure, and nonunited epiphyses, and who had no linear growth but epiphyseal fusion after prolonged thyroid medication, prompts this report. Report of a Case This patient, a 22-year-old white man, was admitted to US Naval Hospital, Oakland, Calif, on Jan 22, 1961, following a hypotensive episode. On the day of admission he experienced nausea, vomiting, and periumbilical pain followed by postural syncope.