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Couturier C, Cneude F, Spiteri A, Nugues F, Debillon T. [Neonatal hyperthyroidism: A sometimes challenging diagnosis]. Arch Pediatr 2017; 24:622-624. [PMID: 28583776 DOI: 10.1016/j.arcped.2017.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 01/11/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
Graves disease complicates two pregnancies out of 1000 and when it is known before pregnancy, it warrants careful monitoring of the fetus and the newborn. We report on a case of neonatal hyperthyroidism, which revealed a previously unknown maternal thyroid disease. In this situation, neonatal signs can be misinterpreted, delaying the diagnosis. Neonatal hyperthyroidism is, however, a therapeutic emergency because of the risk of cardiac and neurological complications. The neonatologist must identify thyroid disease in the absence of a maternal history in order to promptly start therapy.
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Affiliation(s)
- C Couturier
- Clinique universitaire de néonatologie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France; Clinique universitaire de pédiatrie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France.
| | - F Cneude
- Clinique universitaire de néonatologie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France; Clinique universitaire de pédiatrie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France
| | - A Spiteri
- Clinique universitaire de néonatologie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France; Clinique universitaire de pédiatrie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France
| | - F Nugues
- Clinique universitaire de néonatologie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France; Clinique universitaire de pédiatrie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France
| | - T Debillon
- Clinique universitaire de néonatologie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France; Clinique universitaire de pédiatrie, HCE CHU de Grenoble, CS10217, 38430 Grenoble cedex 09, France
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Correia MF, Maria AT, Prado S, Limbert C. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism. BMJ Case Rep 2015; 2015:bcr-2014-209283. [PMID: 25750228 DOI: 10.1136/bcr-2014-209283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis.
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Affiliation(s)
| | - Ana Teresa Maria
- Departamento da Mulher e da Criança, HPP Hospital de Cascais Dr José de Almeida, Alcabideche, Portugal
| | - Sara Prado
- Departamento da Mulher e da Criança, HPP Hospital de Cascais Dr José de Almeida, Alcabideche, Portugal
| | - Catarina Limbert
- Unidade de Endocrinologia, Hospital Dona Estefânia, Lisboa, Portugal
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Ben Ameur K, Chioukh FZ, Marmouch H, Ben Hamida H, Bizid M, Monastiri K. [Neonatal hyperthyroidism and maternal Graves disease]. Arch Pediatr 2015; 22:387-9. [PMID: 25727474 DOI: 10.1016/j.arcped.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/05/2014] [Accepted: 01/13/2015] [Indexed: 11/26/2022]
Abstract
The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests.
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Affiliation(s)
- K Ben Ameur
- Service de réanimation et de médecine néonatale, centre de maternité et de néonatalogie, EPS Fattouma-Bourguiba, 5000 Monastir, Tunisie.
| | - F Z Chioukh
- Service de réanimation et de médecine néonatale, centre de maternité et de néonatalogie, EPS Fattouma-Bourguiba, 5000 Monastir, Tunisie
| | - H Marmouch
- Service de médecine interne-endocrinologie, EPS Fattouma-Bourguiba, faculté de médecine de Monastir, 5000 Monastir, Tunisie
| | - H Ben Hamida
- Service de réanimation et de médecine néonatale, centre de maternité et de néonatalogie, EPS Fattouma-Bourguiba, 5000 Monastir, Tunisie
| | - M Bizid
- Service de réanimation et de médecine néonatale, centre de maternité et de néonatalogie, EPS Fattouma-Bourguiba, 5000 Monastir, Tunisie
| | - K Monastiri
- Service de réanimation et de médecine néonatale, centre de maternité et de néonatalogie, EPS Fattouma-Bourguiba, 5000 Monastir, Tunisie
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