{
  "abstract": "The clinical features of severe hypothyroidism may overlap with those of Down syndrome, delaying diagnosis until complications such as myxedema crisis and massive pericardial effusion develop. Regular thyroid function screening is essential, and hypothyroidism-associated massive pericardial effusion can often be treated conservatively with levothyroxine in the absence of cardiac tamponade.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Practice and Emergency Medicine B.P Koirala Institute of Health Sciences Dharan Nepal.",
    "Department of Cardiology B.P Koirala Institute of Health Sciences Dharan Nepal.",
    "Birat Medical College and Teaching Hospital Tankisinuwari Nepal.",
    "Department Internal Medicine B.P Koirala Institute of Health Sciences Dharan Nepal.",
    "B.P Koirala Institute of Health Sciences Dharan Nepal."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bivek Mishra",
      "orcid": "0009-0002-5384-260X"
    },
    {
      "affs": [
        0
      ],
      "name": "Pujan Pokharel",
      "orcid": "0009-0007-6125-1734"
    },
    {
      "affs": [
        1
      ],
      "name": "Abinash Karki"
    },
    {
      "affs": [
        2
      ],
      "name": "Oshin Rimal",
      "orcid": "0009-0001-9306-9482"
    },
    {
      "affs": [
        3
      ],
      "name": "Ayush Bakhrel"
    },
    {
      "affs": [
        4
      ],
      "name": "Diwakar Koirala",
      "orcid": "0009-0003-2551-7428"
    },
    {
      "affs": [
        4
      ],
      "name": "Ramesh Sapkota",
      "orcid": "0009-0001-3646-4611"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7a0gqsw1e730d.bib",
  "cited_by": 0,
  "doi": "10.1002/ccr3.73795",
  "fulltext_url": "https://europepmc.org/articles/PMC13695029",
  "id": "7a0gqsw1e730d",
  "issns": [
    "2050-0904"
  ],
  "landing_url": "https://europepmc.org/article/MED/42926915",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2712|Thyroid Disorders and Treatments"
    ]
  ],
  "openalex": "W7223444180",
  "pdf_url": "https://europepmc.org/articles/PMC13695029?pdf=render",
  "pmcid": "PMC13695029",
  "pmid": "42926915",
  "published": "2026-10-24",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/7a0gqsw1e730d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42926915",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42926915"
    },
    {
      "first_seen": "2026-10-30T13:44:39Z",
      "native_id": "633b0c1317dc4f63b53c0560830dbe98",
      "source": "doaj",
      "url": "https://doi.org/10.1002/ccr3.73795"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Disorders and Treatments",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Massive Pericardial Effusion as a Manifestation of Severe Autoimmune Hypothyroidism in an Adolescent With Down Syndrome: Importance of Early Recognition and Thyroid Hormone Replacement.",
  "title_text": "Massive Pericardial Effusion as a Manifestation of Severe Autoimmune Hypothyroidism in an Adolescent With Down Syndrome: Importance of Early Recognition and Thyroid Hormone Replacement.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:39Z",
  "url": "https://research.draconitic.com/paper/7a0gqsw1e730d",
  "venue": "Clinical case reports",
  "versions": []
}