An eight-year-old girl referred from Pasanggrahan Hospital was admitted to Tarakan Hospital with

shortness of breath and a history of hyperthyroid on treatment. She has persistent cough and a history of
treatment for tuberculosis for 9 months at the age of 3. Patient is easily fatigued and has difficulty in
gaining weight. In September of 2016 she was hospitalized with lung infection and referred to Harapan
Kita Hospital for complete examination. She was diagnosed with an abnormality on her facial nerves by
the Pediatric Neurologist, and hyperthyroidism by the Pediatric endocrinologist with symptoms of
exophthalmos and diffused goiter and is being treated at the moment with PTU and propranolol. Pediatric
Genetic examination findings shows abnormalities in chromosomes 12 and 14. Physical examinations
revealed dysmorphic face, exophthalmos, tears crub, diffused struma, macrotia, macrolabia, pectus
excavatum. Laboratoric findings TSH > TSH >60.00 ^IU/mL , FT4 1.35 pmol/L. Patient the was
treated in Pediatric ICU for 10 days.