Three Case Reports of Neonatal Hyperthyroidism

Abstract

To emphasize the causes, clinical features, diagnosis, management, and prognosis of hyperthyroidism in newborns, 3 cases of neonatal hyperthyroidism were analyzed. The cases were all low birth weight babies, and 2 of them were premature, the other was a term infant. Their mothers' histories were all positive for Graves' disease. In all cases, the infants exhibited tachycardia on admission. Case 1 presented mainly as splenohepatomegalia, case 2 presented mainly as heart failure and pneumonedema, whereas case 3 presented as hepatitis syndrome. The test of thyroid function and history of the mother confirmed the diagnosis of hyperthyroidism. Antithyroid drug therapy was administrated for all 3 cases, 2 with propylthiouracil and 1 with tapazole. In cases 1 and 2, thyroid function recovered after 4 to 5 weeks of treatment, and persisted for the following 3 months. Case 3 recovered after 3 months of therapy, which might be associated with a delay of diagnosis and severe symptoms. Neonatal hyperthyroidism is a rare disorder and usually associated with maternal Graves' disease. Although most neonatal hyperthyroidism is temporary, it may affect many organ systems and cause developmental delay in infants. Early diagnosis and prompt treatment consisting of antithyroid drugs in conjunction with iodine, β-receptor blocking agents, and at times glucocorticoids and digoxin, are the key elements in management of this disease.