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Arch Surg. 1941;42(6):1048-1053. doi:10.1001/archsurg.1941.01210120083009.
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The inadequately treated child with hypothyroidism may present diagnostic problems related to growth, and because of this a tendency has arisen to ascribe to understature an element of anterior pituitary growth deficiency and to administer anterior pituitary extracts containing the growth-stimulating factor, exclusively or combined with wholly inadequate thyroid therapy.1 The pallor associated with this condition occasionally leads to a diagnosis of secondary anemia of unknown cause. The constipation, protuberant abdomen and megacolon that may be observed in the inadequately treated cretin may be mistaken for Hirschsprung's disease. We are presenting a case in which these diagnostic difficulties were encountered.

REPORT OF CASE  In October of 1939 M. B., a white boy aged 15 years, was referred to the hematology department because of anemia. Hematologic studies, including a sternal puncture, revealed an anemia which was not characteristic of any definite disease. This patient was referred to us in January


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