Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1098 Jiefang Avenue, Wuhan, Hubei, 430077, P.R. China.
BMC Pediatr. 2024 Jan 13;24(1):43. doi: 10.1186/s12887-024-04531-6.
To outline the clinical signs, diagnosis, and course of care for a single case of neonatal hyperthyroidism while also summarizing common diagnostic errors related to this condition.
Medical records of the neonate of hyperthyroidism were collected and analyzed in combination with literature.
The neonate's mother had thyroid disease, but her thyrotropin receptor antibody (TRAb) levels were not monitored during pregnancy. The neonate exhibited typical symptoms of hyperthyroidism on the day of birth but was not diagnosed until 15 days later. Impaired liver (cholestasis, elevated liver enzymes) and cardiac function (pulmonary hypertension, right heart enlargement) are the main manifestations. Treatment with methimazole (1.0 mg /kg·d) and propranolol (2.0 mg /kg·d) led to recovery, and the neonate stayed in the hospital for 27 days before being discharged with medication. The diagnosis was temporary hyperthyroidism, and the medication was discontinued at 72 days of age.
It is important to strengthen the management of high-risk pregnant women with thyroid disease. Monitoring TRAb levels in both mothers and neonates should be done dynamically to enable early prediction and diagnosis of neonatal hyperthyroidism. Most neonates with hyperthyroidism have a good prognosis when timely and appropriate medical treatment is provided.
总结 1 例新生儿甲状腺功能亢进症的临床特点、诊断及治疗经过，并总结该疾病常见的误诊原因。
收集并分析甲状腺功能亢进症新生儿的病历资料，并结合文献进行总结。
患儿母亲患有甲状腺疾病，但在妊娠期间未监测促甲状腺素受体抗体（TRAb）水平。患儿出生当天即出现典型的甲状腺功能亢进症症状，但直到 15 天后才被诊断出来。肝损伤（胆汁淤积、肝酶升高）和心脏功能障碍（肺动脉高压、右心增大）是主要表现。采用甲巯咪唑（1.0mg/kg·d）和普萘洛尔（2.0mg/kg·d）治疗后恢复，患儿住院 27 天，带药出院。诊断为暂时性甲状腺功能亢进症，72 天时停药。
加强甲状腺疾病高危孕妇的管理非常重要。应动态监测母婴 TRAb 水平，以便早期预测和诊断新生儿甲状腺功能亢进症。大多数新生儿甲状腺功能亢进症经及时、恰当的治疗后预后良好。
