RESUMEN
A 15-mth-old male child of consanguineous parents, presented with classical features of congenital hypothyroidism. Serum total thyroxine (T4), total triiodothyronine (T3) and TSH were low. There was no evidence of deficiency of other pituitary hormones. Magnetic resonance imaging of the pituitary was normal. TSHB gene sequencing revealed a homozygous missense mutation due to single base substitution G?A at codon 85 resulting in change from Glycine to Arginine. This mutation in TSHB gene has been reported earlier in three cases with similar phenotype from Japan.
Asunto(s)
Encéfalo/patología , Humanos , Hipotiroidismo/genética , Hipotiroidismo/metabolismo , Hipotiroidismo/patología , Lactante , Imagen por Resonancia Magnética , Masculino , Mutación Missense/genética , Tirotropina de Subunidad beta/genética , Tiroxina/metabolismo , Triyodotironina/metabolismoRESUMEN
A 13 year old boy presented to us with short stature. Evaluation revealed growth hormone (GH) deficiency. He was treated with GH replacement for 10 months and to further boost up the growth potential, an aromatase inhibitor Letrozole was added to GH therapy. After one year of combination therapy, patient had significant improvement in predicted adult height without a negative impact on pubertal progression.