CLINICAL CASE CHALLENGE
A case of constipation, growth retardation and thyroid disease
Francesca Gaeta
Dipartimento Materno Infantile ASL Avellino UOSD Pediatria e Neonatologia
A 9-year-old girl presented with growth deceleration, fatigue, and neck swelling. Laboratory investigations revealed primary hypothyroidism without evidence of thyroid autoimmunity. Nutritional assessment disclosed a strict vegan diet, appropriately supplemented with vitamin B12 and vitamin D, but providing insufficient trace elements intake.