Tiny and Tachycardic: Neonatal Thyrotoxicosis in a Preterm Infant

Résumé fourni par la source

Neonatal thyrotoxicosis is uncommon compared to congenital hypothyroidism but can lead to significant morbidity and mortality if unrecognized. We report a case of neonatal thyrotoxicosis in a preterm infant whose presentation was initially masked by features of prematurity. A female infant was delivered at 31 weeks and 5 days via emergency Caesarean section for fetal distress. The mother, a 26-year-old primigravida with gestational diabetes, presented with chorioamnionitis and tachycardia. The infant required respiratory support and exhibited persistent tachycardia initially attributed to prematurity. Thyroid function tests showed suppressed TSH and elevated free T4 levels. Clinically, the baby was small for gestational age with poor muscle bulk, jitteriness, and poor weight gain. Maternal history revealed symptoms of hyperthyroidism with positive anti-TPO antibodies. Neonatal thyrotoxicosis was diagnosed, and Carbimazole with Propranolol was initiated on day 12, resulting in clinical and biochemical improvement. Antithyroid treatment was discontinued by day 63, followed by a transient hypothyroid phase managed with Levothyroxine until 5 months. This case highlights the importance of clinical vigilance and early thyroid screening in at-risk neonates. Prompt diagnosis and targeted therapy can prevent complications and lead to favourable outcomes.

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