Lim Gwan Yong, Thashin Ashta, Joy Gayathri, Cheyne Ithamar, Mikaszewska-Sokolewicz Małgorzata
Anesthesiology and Intensive Care Scientific Circle, Medical University of Warsaw, 02-091 Warsaw, Poland.
Clinic of Anesthesiology and Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Reports (MDPI). 2025 Apr 23;8(2):53. doi: 10.3390/reports8020053.
: Neonatal hemochromatosis is a rare iron overload disorder that causes severe liver injury in newborns, typically with extrahepatic siderosis. Diagnosis of neonatal hemochromatosis is usually confirmed through a biopsy and MRI, demonstrating deposition of iron and liver failure. However, in severe patients who are not able to undergo biopsy, the diagnostic and management method remains unknown. : We present an unusual case of neonatal hemochromatosis without extrahepatic iron deposition in a 9-day-old male who showed signs of liver failure and respiratory distress. This case suggests that when the risks of biopsy outweigh its benefits, a diagnosis may be reached based on clinical evaluation and MRI findings. Early high-dose intravenous immunoglobulin therapy improved liver function and led to recovery, highlighting the need for early therapeutic intervention in neonatal hemochromatosis. : This case highlights that the absence of extrahepatic siderosis cannot exclude a diagnosis of neonatal hemochromatosis, and high doses of IVIG should be administered promptly when neonatal hemochromatosis is suspected to maximize therapeutic effectiveness.
新生儿血色沉着症是一种罕见的铁过载疾病,可导致新生儿严重肝损伤,通常伴有肝外铁沉积。新生儿血色沉着症的诊断通常通过活检和磁共振成像(MRI)来确认,表现为铁沉积和肝功能衰竭。然而,对于无法进行活检的重症患者,诊断和管理方法仍不明确。
我们报告了一例9日龄男性新生儿血色沉着症的罕见病例,该患儿无肝外铁沉积,但出现肝功能衰竭和呼吸窘迫迹象。该病例表明,当活检风险大于其益处时,可根据临床评估和MRI结果做出诊断。早期大剂量静脉注射免疫球蛋白治疗改善了肝功能并实现康复,凸显了对新生儿血色沉着症进行早期治疗干预的必要性。
该病例突出表明,肝外无铁沉积不能排除新生儿血色沉着症的诊断,当怀疑新生儿血色沉着症时,应及时给予大剂量静脉注射免疫球蛋白,以最大限度提高治疗效果。