ESPE Abstracts

Introduction: In the last year, the pediatric services have seen a reduction of up to 50% of the consultations and 1/3 of the admissions to the hospitalization ward; However, the existence of other pathologies cannot be forgotten despite the current situation, such as hypothyroidism, diabetic ketoacidosis, short stature, precocious puberty, etc., as far as endocrinology is concerned. Difficulty in accessing primary care, non-contact visits, along with the fear of families to go to the health field, can lead to a delay in the diagnosis of important pathologies. According to INE 2020 (National Institute of Statistics), there is an increase in mortality in Spain not directly attributable to COVID19 infections.

Clinical Case: A 35-month-old girl referred to outpatient visits for thyroid dysfunction detected in a non-face-to-face primary care consultation. Moroccan family, first-born with normal somatometry and neonatal screening at birth. Age-appropriate growth growth up to 2 years. The family reports 8 months before, coinciding with the onset of the pandemic, that the patient is more tired, dry skin, hoarse tone of voice and significant hair loss. Later, she presented psychomotor retardation, failure to thrive and swelling of the face, a fact that alarmed the family and for which they decided to consult in primary care. He does not refer associated goitrogens. No family history of thyroid function alteration. A blood test is performed where an elevated TSH> 500 mU/l, FT4 <0.42 ng/dl, FT3 <1.0 pg/ml, Thyroperoxidase, ATPO Ac 4 IU/ml, Thyroglobulin 63.59 ng/ml, Thyroglobulin (ATG), Ab 203 IU/ml. Urine test in normal ranges without proteinuria. In a patient with severe autoimmune acquired hypothyroidism, treatment with sodium levothyroxine is started and a thyroid ultrasound is requested to complete the study. CONCLUSIONS: As pediatricians we must be attentive to alarm symptoms, be careful in the telematic assistance that is offered and above all assess if this is the most appropriate, since the essence of the "Lex artis" can be lost, observing and exploring our small patients.