A Baby With Generalized Edema

A 2-month-old Caucasian female infant was referred to the pediatric endocrine clinic with a diagnosis of congenital hypothyroidism, which was discovered by a neonatal screening test. She was born in a community hospital by caesarean section at 34 weeks of gestation secondary to oligohydramnios, fetal distress, and partial placental abruption. The mother was 32 years of age, and it was her first pregnancy. The baby’s birth weight was 4 lb 15 oz, and the birth length was 17 in. The mother had been concerned about the edema of labia and lower extremities since the birth, which worsened over the last few weeks. Abdominal distension was also noted over a few weeks, and the baby was having breathing difficulty. The baby had been vomiting off and on since birth and did not improve with formula changes. Over the period of the last 24 hours her left foot was not only swollen but also red and apparently painful. According to the mother, the baby was very fussy and ill appearing with increased breathing difficulties.