Welcome to the PediPro video series, where real-world pediatric cases highlight diagnostic challenges and clinical insights. In this 11th case, Dr. Durga Prasad shares the story of a 13-year-old girl with abdominal distension and polyserositis, initially suspected to have tuberculosis or liver disease. Subtle signs like delayed puberty, constipation, and puffy face led to the unexpected diagnosis of severe hypothyroidism. With thyroxine therapy, the child made a full recovery. This case highlights the importance of considering endocrine causes in unexplained systemic presentations.