Alhassan Abdul-Mumin
1,2* 
, Kingsley A Bimpong
2 , Emmanuel Ameyaw
3,4 1 Department of Paediatrics and Child Health, School of Medicine, University for Development Studies, Tamale, Ghana
2 Department of Paediatrics and Child Health, Tamale Teaching Hospital, Tamale, Ghana
3 Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
4 Directorate of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Abstract
Congenital hypothyroidism is a common inborn endocrine disorder. Asymptomatic presentation in majority of cases mean that its diagnosis may be missed especially in settings where newborn screening is absent. We present a case of delayed diagnosis of congenital hypothyroidism and emphasize on need for high level of suspicion to aid prompt diagnosis and treatment. Our case is a 3 year, 4 months old male, who was first seen at 5 months of age on account of poor growth. He passed meconium after day four of life, developed jaundice in first week of life, and slept a lot in neonatal period. He had coarse faces, protruding tongue, widened anterior fontanelle and herniation of umbilicus. He was started on oral levothyroxine 50 microgram daily. In resources limited settings where universal newborn screening is absent, healthcare workers should have a high level of suspicion in picking up the early signs of the condition.