Abstract
Autoimmune thyroiditis is the most common cause of acquired thyroid disease in children and adolescents. With a very heterogeneous initial presentation, diagnosis can be a challenge. Untreated, hypothyroidism has a significant impact on overall health and quality of life. Best outcome requires early detection as well as appropriate treatment. We present a case report of primary acquired hypothyroidism with a special presentation and a brief narrative review about hypothyroid autoimmune thyroiditis. Besides, we signal the potential for delayed diagnosis in children with developmental disabilities.