A 2 week old child shows difficulty feeding, somnolence, failure to thrive, and constipation. An ale pediatrician orders blood studies that demonstrate low T4 and high TSH. If appropriate therapy is not promptly instituted, which of the following complications would most likely occur?

The disease is infantile hypothyroidism, which can produce the syndrome of cretinism if left untreated. Early manifestations include those listed in the question stem. Later manifestations of untreated disease include impaired skeletal growth, protruding abdomen, dry skin, and, most seriously, neurologic problems that typically include deaf-mutism, spasticity, and profound mental retardation. Many hospitals routinely screen neonates for hypothyroidism and institute appropriate thyroid hormone replacement therapy immediately if necessary, thereby preventing the many problems these children would otherwise have. Associate bronchiectasis with the inherited childhood disease cystic fibrosis. Associate gigantism with pituitary tumors, which can be congenital. Associate hepatic cirrhosis in childhood with the inherited disease alpha-1- antitrypsin deficiency. Ref: Sokol R.J., Narkewicz M.R. (2012). Chapter 22. Liver & Pancreas. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.