Neonatal Graves' Disease with Maternal Hypothyroidism

Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a m...

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Bibliographic Details
Main Authors: Gangaram Akangire, Alain Cuna, Charisse Lachica, Ryan Fischer, Sripriya Raman, Venkatesh Sampath
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2017-07-01
Series:American Journal of Perinatology Reports
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606365
Description
Summary:Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.
ISSN:2157-6998
2157-7005