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  1. Patent posterior fontanel and wide open cranial Sutures
  2. Skin dry coarse and thick, mottled
  3. Abdomen - protuberant
  4. Birth weight higher than the average but they are lethargic.
  5. They sleep most of the time, cry little, feed poorly and often get chocking spells during feeding.
  6. Prolonged physiological jaundice
  7. Constipation
  8. Hypothermia
  9. Screening : Best with cord blood, or after 72 hrs 


Short neck with supraclavicular fat and hoarse voice


Umbilical hernia


Dentition and skeletal maturation is significantly delayed.


Refractory anemia is common.


Acquired Hypothyroidism

  1. Short and stocky with disproportionately large head and trunk as compared to limbs
  2. Ratio of upper and lower segments of body is increased**
  3. Puberty is delayed Q 


  1. Serum levels of T4 and T3 low and TSH elevated.
  2. Scrum prolactin is elevated. 


  1. Retarded bone age (Absence of distal femoral epiphysis at birth) and epiphyseal dysgenesis
  2. Beaking of 12th thoracic 1st or 2nd lumbar vertebra.
  3. Skull x-ray shows large fontanel, wide sutures and wormian bones:
  4. Serum cholesterol is usually elevated. 

Neonatal Screening for Hypothyroidism

  1. By measurements of blood T4 and TSH
  2. Low T4 with elevated TSH - Primary hypothyroidism.
  3. Low T4 and normal or decreased TSH - Thyroid binding globulin deficiency or secondary hypothyroidism

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