A 2-year-old boy is brought to the physician for thyroid evaluation. His mother reports that he has been a bit irritable. Vitals are within normal limits. Physical examination is unremarkable. Serum TSH is 3.0 mIU/L (NR 0.5-5.0), Free T4 is 1.2 ng/dL (NR 0.8-1.8), Total T4 is 3 ug/dL (NR 5-12). What’s the diagnosis?
Cretinism
Congenital subclinical hypothyroidism
Euthyroid sick syndrome
Silent thyroiditis
Thyroid-binding globulin deficiency
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Cut-to-the-chase Answer (0:58):
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HY USMLE Answer (5:25):