Department of Pediatrics, TN Medical College and BYL Nair Charitable Hospital, Dr. AL Nair Road, Mumbai Central, Mumbai, 400008, India.
Indian J Pediatr. 2019 Feb;86(2):180-182. doi: 10.1007/s12098-018-2766-1. Epub 2018 Aug 20.
A seven-months-old girl under treatment for pneumonia presented with generalized edema, decreased urinary output and was found to have hypertension, muco-cutaneous fungal infection and pulmonary hypertension. Investigations revealed that she had heavy proteinuria, hypertriglyceridemia, hypoalbuminemia and elevated levels of free T3 and T4 with suppression of TSH levels in the serum. A diagnosis of autoimmune thyroiditis (AT) in thyrotoxic phase was made on the basis of clinical presentation and presence of anti-TPO antibodies and reduced uptake in thyroid (technetium) scintigraphy. The child responded to carbimazole therapy and propranolol. The case is presented to remind pediatricians about the rare occurrence of auto-immune thyroiditis in infancy with rare complications such as nephrotic syndrome and pulmonary hypertension.
一名七个月大的正在接受肺炎治疗的女婴出现全身水肿、尿量减少，并被发现患有高血压、黏膜皮肤真菌感染和肺动脉高压。检查显示她有大量蛋白尿、高三酰甘油血症、低白蛋白血症以及游离 T3 和 T4 水平升高，同时血清促甲状腺激素水平受到抑制。根据临床表现以及抗甲状腺过氧化物酶抗体和甲状腺（锝）闪烁扫描摄取减少，诊断为甲状腺功能亢进期自身免疫性甲状腺炎（AT）。该患儿对甲巯咪唑和普萘洛尔治疗有反应。本病例旨在提醒儿科医生注意婴儿期自身免疫性甲状腺炎罕见的发病情况，以及肾病综合征和肺动脉高压等罕见并发症。
