A 5-year-old female child presented with progressively increasing thyroid swelling. She was emaciated with a diffusely enlarged goiter. There was bilateral exophthalmos (Fig. 1), muscular weakness and emotional la- bility. She weighed 8 kg, had height of 107 . cm, and had a sleeping pulse rate of 132/min. Investigations revealed a serum T3 of 2.1 ng/ml, T4 of 2.7 ng/dl and TSH of 0.4 IlV/m!. Thyroid scan revealed a hyperfunctioning thyroid gland. She was treated with neomercazole (5 mg twice a day) which resulted in amelioration of clinical signs over 2 months.

Fig. 1. Photograph showing goiter with bilateral exophthalmos

Dilip Kumar Paul,
Madhurima Lahiri,
Department of Pediatric Medicine,
Dr. B.C. Roy Memorial Hospital
for Children,
Calcutta 700 054, India.