OBJECTIVE: To show the value of using the follow-up growth charts in clinical evaluation of obese children and adolescents. CASE DESCRIPTION: A 12 years and 11 months-old girl referred to a tertiary out-patient clinic to evaluate obesity and lipid abnormalities. She had weight gain since eight years old, had no physical activity and followed adequate eating habits. Obesity was referred in father's family. In physical examination, she looked well, with lack of body hair, generalized mixedema, dry and rough skin. Weight was between percentile 90 and 97; BMI was over the percentile 97 and height was under the growth channel. LABORATORY EXAMS: T4: 0.04ng/dL, TSH: >100uUI/mL, total cholesterol: 326mg/dL, HDL cholesterol: 34mg/ dL, LDL cholesterol: 45mg/dL, triglycerides: 1599mg/dL, fasting glicose: 81mg/dL and hemogram with normocromic and normocytic anemia. Hypothyroidism diagnosis was made and thyroid hormone was introduced with good response. The patient brought 23 previous heights and weight measurements, which showed height drop and weight gain in the growth chart, all of them undervalued. COMMENTS: Growth chart analysis is important for the follow-up of children and adolescents, especially those with overweight and obesity. The linear growth slowing suggests an associated sickness; in this case, an acquired hypothyroidism.
growth; hypothyroidism; obesity