一例因母体自身免疫性甲状腺功能亢进导致新生儿甲状腺毒症的病例报告。

A case report of neonatal thyrotoxicosis due to maternal autoimmune hyperthyroidism.

作者信息

Markham Lori A, Stevens Debra L

机构信息

Department of Neonatology, Baylor University Medical Center, Dallas, TX 75246, USA.

出版信息

Adv Neonatal Care. 2003 Dec;3(6):272-82; quiz 283-5. doi: 10.1016/j.adnc.2003.09.004.

DOI:10.1016/j.adnc.2003.09.004

PMID:14695499

Abstract

A case of neonatal thyrotoxicosis secondary to maternal autoimmune hyperthyroidism is reported in an infant born at 34 weeks gestation who presented with tachycardia, jitteriness, diarrhea, and a small goiter. Propranolol and oxygen were used to treat high-output cardiac failure and transient persistent pulmonary hypertension. The infant's response to propylthiouracil therapy, gradual resolution of cardiac and systemic symptoms, and normaliziation of thyroid studies are described. Thyroid physiology and function and the special considerations in a premature infant are reviewed. An overview of maternal autoimmune hyperthyroidism and the implications for the developing fetus and neonate are presented. The risk factors for, and clinical presentation of, hyperthyroidism are outlined and treatment strategies highlighted. The nursing care of infants with hyperthyroidism is carefully described with an emphasis on the surveillance for and management of multisystem manifestations.

摘要

本文报道了一例孕34周出生的新生儿甲状腺毒症病例，该患儿继发于母亲自身免疫性甲状腺功能亢进症，表现为心动过速、易激惹、腹泻和小甲状腺肿。使用普萘洛尔和氧气治疗高输出量心力衰竭和短暂持续性肺动脉高压。描述了婴儿对丙硫氧嘧啶治疗的反应、心脏和全身症状的逐渐缓解以及甲状腺检查结果的正常化。回顾了甲状腺生理功能以及早产儿的特殊注意事项。概述了母亲自身免疫性甲状腺功能亢进症及其对发育中胎儿和新生儿的影响。概述了甲状腺功能亢进症的危险因素和临床表现，并突出了治疗策略。详细描述了甲状腺功能亢进症婴儿的护理，重点是对多系统表现的监测和管理。