Upper gastrointestinal bleeding: A rare presenting sign of pediatric hypothyroidism

Nicholas Aldredge , Sara A. DiVall , Yongtian T. Tan
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Abstract

Background

Severe pediatric hypothyroidism is a relatively rare endocrine disorder characterized by inadequate thyroid hormone production or action in children. It can have significant effects on various organ systems, including the gastrointestinal (GI) tract, and cause upper GI bleeding (UGIB). It can be challenging to diagnose as the cause in the emergency department (ED).

Case report

We present the case of a 13-year-old previously healthy male presenting with hematemesis as the chief complaint to the pediatric emergency department, who was subsequently found to have severe hypothyroidism based on a constellation of vital sign abnormalities in the absence of other likely etiologies. This case illustrates the importance of considering endocrinopathies as part of the overall differential diagnoses for a pediatric patient presenting with isolated hematemesis, especially if there is a disparity between vital signs and other clinical signs.

Why should an emergency physician be aware of this?

Recognizing pediatric hypothyroidism as a potential cause of UGIB presents a particular diagnostic challenge for emergency physicians. Symptoms of pediatric hypothyroidism can be varied, and UGIB in this setting is a rare and poorly understood clinical entity. Timely diagnosis and treatment of hypothyroidism are crucial to prevent further complications and optimize the child's growth and development.
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上消化道出血:小儿甲状腺功能减退症的罕见症状
背景严重的小儿甲状腺功能减退症是一种相对罕见的内分泌疾病,其特点是儿童体内甲状腺激素分泌或作用不足。它可能对包括胃肠道在内的多个器官系统产生重大影响,并导致上消化道出血(UGIB)。病例报告我们介绍了这样一个病例:一名 13 岁的健康男性以吐血为主诉到儿科急诊就诊,随后根据一系列生命体征异常发现他患有严重的甲状腺功能减退症,但没有其他可能的病因。本病例说明,对于出现孤立性吐血的儿科患者,将内分泌疾病作为整体鉴别诊断的一部分非常重要,尤其是在生命体征与其他临床体征不一致的情况下。小儿甲状腺功能减退症的症状多种多样,在这种情况下发生的 UGIB 是一种罕见且鲜为人知的临床症状。及时诊断和治疗甲状腺功能减退症对于预防进一步的并发症和优化儿童的生长发育至关重要。
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来源期刊
JEM reports
JEM reports Emergency Medicine
自引率
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审稿时长
54 days
期刊最新文献
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