title: Recurrent pericardial effusion associated with hypothyroidism in Down Syndrome: a case report.
abstract: BACKGROUND
  The complex of Down Syndrome-hypothyroidism-pericardial effusion is largely unreported in sub-Sahara.
  
  
  OBJECTIVE
  To present and highlight an unusual manifestation of hypothyroidism.
  
  
  METHODS
  A 16-year-old girl with confirmed Down Syndrome presented with complaints of generalised body swelling of eight months' duration. Her work-up consisted of full clinical and laboratory evaluation including ECG and echocardiography.
  
  
  RESULTS
  The patient was diagnosed of Down's Syndrome at birth but was lost to follow-up after at eight years of age. Body swelling was associated with clinical features of heart failure. Echocardiography showed massive pericardial effusion. Serum l-thyroxine was less than 0.5mg/dl and TSH >40iu/l. The heart failure and menstrual irregularities responded to l-thyroxine therapy.
  
  
  CONCLUSIONS
  This appears to be the first report of the complex of Down syndrome, hypothyroidism and pericardial effusion in a Nigerian child. Thyroid function test is therefore recommended as a part of baseline investigation for Nigerian children with Down syndrome as is the practice.
authors: Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria. Maxejen@yahoo.com
authors: M U
authors: MU
authors: Anah
authors: V O
authors: VO
authors: Ansa
authors: A U
authors: AU
authors: Etiuma
authors: E E
authors: EE
authors: Udoh
authors: E O
authors: EO
authors: Ineji
authors: A A
authors: AA
authors: Asindi
mesh_terms: D000293:Adolescent; D004314:Down Syndrome / Q000150:complications*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013972:Thyrotropin; D013974:Thyroxine