Solitary median maxillary central incisor with congenital strabismus and autoimmune thyroiditis in a young child

BMJ Case Rep. 2021 Feb 23;14(2):e240418. doi: 10.1136/bcr-2020-240418.

Abstract

Single median maxillary central incisor (SMMCI) syndrome is rare. It is commonly associated with other midline defects. About 50% of children with SMMCI have short stature, associated with isolated growth hormone deficiency or panhypopituitarism.A 6-year-old girl presented to us with worsening convergent squint, slowing linear growth and a suspected pituitary macroadenoma on neuroimaging. The key findings on examination included a disproportionate short stature, SMMCI, congenital abduction defect and pseudohypertrophy of calf muscles with myopathy. The evaluation showed autoimmune thyroiditis with pituitary hyperplasia. Bone age corresponded to 3 years.Three months after initiation of thyroxine, her myopathy resolved, and the hormone profile and neuroimaging were normal. Autoimmune thyroiditis in association with SMMCI is not reported previously. This case study emphasises the importance of growth monitoring and the exclusion of common treatable conditions.

Keywords: cranial nerves; dentistry and oral medicine; muscle disease; thyroid disease.

Publication types

  • Case Reports

MeSH terms

  • Anodontia
  • Child
  • Female
  • Holoprosencephaly*
  • Humans
  • Incisor / abnormalities
  • Maxilla
  • Strabismus*
  • Syndrome
  • Thyroiditis, Autoimmune*

Supplementary concepts

  • Single upper central incisor