ODP374 Abdominal Distention as a Unique Sign of Congenital Hypothyroidism

BACKGROUND: Most neonates with congenital hypothyroidism have a normal appearance at birth. Infrequent clinical presentations have been reported, including abdominal distention as the only sign, which remit with the initiation of levothyroxine therapy. CLINICAL CASE: Female newborn, full-term, appropriate weight for gestational age, six days old, who presented abdominal distension, without vomiting and with normal meconium elimination. No visceromegaly or abdominal masses were palpated. With the diagnosis of sepsis, treatment was started with ampicillin and amikacin, decompressive nasogastric tube and intravenous fluids. Abdominal X-ray showed intestinal distension. The requested cultures were negative. On the seventh day of life a TSH level of 89 mlU/L was reported; the free T4 value was analyzed and was found to be low. With the diagnosis of congenital hypothyroidism, levothyroxine therapy was indicated, and the abdominal distension remitted one week after initiation of therapy. CONCLUSION: Most cases of congenital hypothyroidism are asymptomatic; abdominal distension, as the only sign of congenital hypothyroidism, is caused by the lower intestinal motility frequently observed in congenital hypothyroidism. Presentation: No date and time listed