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Solitary median maxillary central incisor with congenital strabismus and autoimmune thyroiditis in a young child
  1. Tom Alex and
  2. Rathika Damodara Shenoy
  1. Pediatrics, KS Hegde Medical Academy, NITTE Deemed to be University, Mangalore, India
  1. Correspondence to Dr Rathika Damodara Shenoy; rathika.shenoy{at}


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.

  • thyroid disease
  • dentistry and oral medicine
  • muscle disease
  • cranial nerves

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  • Contributors Report was written by TA. Supervised by RDS and acts as guarantor. Patient was under her care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.