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    Suggest treatment for persistent leg pain in a child

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Posted on Mon, 27 Feb 2017 in Thyroid Problem and Hormonal Problems
Question: Hi Doctor,
This is about my daughter XXXXXXX she is 4 1/2 years old.
She is bottle fed from birth.
We saw sudden weight rise in last 1 year and she complained about leg pains.We have visited General physician near our home and he suggested Thyroid profile and LFT test.
LFT is normal as per lab reports, but she has higher levels of T3 and TSH. Attached are the reports for your reference.
Please provide your assistance and medication if required.
doctor
Answered by Dr. Minal Mohit 26 hours later
Brief Answer:
sub clinical hypothyroidism

Detailed Answer:
Dear XXXXXXX hi!
welcome to HCM. I understand your concern.
let me make clear that we will be taking up two things separately.
1. thyroid
2. weight
thyroid is not that bad to give weight gain in your baby's case.
so , let me know her present weight and height, before i comment and also give me her weight change over 1 year.
As of thyroid, it is subclinical, i.e. to take a call , to treat or not to treat, we must find out her antibodies level, TPO antibodies and TGA antibodies. also kindly tell me if there is a family history of thyroid disorder?
regards!
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Minal Mohit 9 minutes later
Dear Dr XXXXXXX
Thanks a lot for the response.

Regarding your queries, please find response below.

Height = 3.7 feet
Weight = 27 KG

Change in weight in last one year (around 7 kg)

Regarding the statement "we must find out her antibodies level, TPO antibodies and TGA antibodies". Please inform, if we need to go any test for the same?

doctor
Answered by Dr. Minal Mohit 4 hours later
Brief Answer:
significantly overweight for age.

Detailed Answer:
Dear sir, i agree, child is significantly overweight for age.
do we have any more records of her height and weight over the previous years?
her exact date of birth?
kindly do a fasting cortisol level, and yes antibodies TPO and TGA.
i will re-emphasize, thyroid is less likely the culprit here. please check serum cortisol fasting sample, 8 am and post me the reports.
regards!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Minal Mohit 19 hours later
Dear Doctor,

Below is the list of her weight/height on different dates.

1. On Birth(29-August-2012) : 2.4 Kg
2. 21/10/2013 : 10 Kg
3. 12/05/2014 : 12.640 Kg/83.7 cm
4. 19/08/2014 : 13 Kg/86 cm
5. 10/02/2015 : 15.88 Kg/95 cm
6. 16/01/2016 : 19.2 Kg/100 cm
7. 29/01/2016 : 18.8 Kg/101.3 cm
8. 07/09/2016 : 22 Kg
9. Latest : 26 Kg/3.7 feet



Major change in 2016 -- Regular schools started.
Leave home for school @7AM and come back @2.30 PM

Diet schedule

Before going to school - Nothing
Lunch@10.30 AM in school - Mostly 2 chapatis + vegetables of the season XXXXXXX Lunch@12.30 PM in school - 1 fruit
Lunch@3PM at home - Mostly khichdi
Snacks@5.30PM at home - 1 glass milk (150-200 ml)
Dinner@7PM at home - Daal Rice or 2 chapatis + vegetables

About reports, we will do and update you.

One important point for your information, She is formula milk fed from birth.

Hi Doctor,

Please note we have gone for confirmation test from Lal path labs . Reports attached fyr.
doctor
Answered by Dr. Minal Mohit 21 hours later
Brief Answer:
we need to test the child.

Detailed Answer:
dear XXXXXXX
child has been overweight since the very beginning. but in last 6 months she has gained some 4 kg.
let us do the tests and then we will discuss again.
regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 836 Questions

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