Neonatal Graves disease with persistent hypoglycemia: A case report
Neonatal Graves disease is the most common cause of hyperthyroidism during the newborn period. Maternal Graves disease increases the risk of intrauterine growth restriction, small for gestational age, and neonatal Graves disease. Intrauterine growth restriction and small for gestational age are asso...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-03-01
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| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X241237433 |
| _version_ | 1797268046437416960 |
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| author | Samantha Fine Michael Gottschalk Krishelle Marc-Aurele |
| author_facet | Samantha Fine Michael Gottschalk Krishelle Marc-Aurele |
| author_sort | Samantha Fine |
| collection | DOAJ |
| description | Neonatal Graves disease is the most common cause of hyperthyroidism during the newborn period. Maternal Graves disease increases the risk of intrauterine growth restriction, small for gestational age, and neonatal Graves disease. Intrauterine growth restriction and small for gestational age are associated with hypoglycemia and transient neonatal hyperinsulinism. Neonatal Graves disease with severe persistent hypoglycemia has not been well described. We present the case of a female patient born at 34 weeks and 3 days with a birth weight of 1.6 kg (fifth percentile) to a mother with recent treatment for Graves disease. Prenatal ultrasounds were significant for intrauterine growth restriction and small for gestational age. The mother did not begin hyperthyroidism medical therapy until 23 weeks and 2 days of gestation. After the infant was born, the infant not only had symptoms of hyperthyroidism such as tachycardia and abnormal thyroid values but also had persistent hypoglycemia, which could be due to maternal propranolol usage, prematurity, IUGR, increased metabolism due to neonatal Graves, and transient stress-induced hyperinsulinism. The infant was started on methimazole for hyperthyroidism and propranolol for tachycardia. She was also started on diazoxide for persistent hypoglycemia. By 6 months of age, the hyperthyroidism and hypoglycemia had resolved. This is an interesting case of neonatal Graves disease with severe persistent hypoglycemia which we suspect is due to transient neonatal hyperinsulinism induced by multiple stress responses. |
| first_indexed | 2024-04-25T01:26:15Z |
| format | Article |
| id | doaj.art-e06e9f7c5fd54e53859331b9de33f114 |
| institution | Directory Open Access Journal |
| issn | 2050-313X |
| language | English |
| last_indexed | 2024-04-25T01:26:15Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj.art-e06e9f7c5fd54e53859331b9de33f1142024-03-08T21:04:40ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2024-03-011210.1177/2050313X241237433Neonatal Graves disease with persistent hypoglycemia: A case reportSamantha Fine0Michael Gottschalk1Krishelle Marc-Aurele2Department of Pediatrics, University of California San Diego Jacobs Medical Center, San Diego, CA, USADepartment of Pediatrics, University of California San Diego Jacobs Medical Center, San Diego, CA, USADepartment of Pediatrics, University of California San Diego Jacobs Medical Center, San Diego, CA, USANeonatal Graves disease is the most common cause of hyperthyroidism during the newborn period. Maternal Graves disease increases the risk of intrauterine growth restriction, small for gestational age, and neonatal Graves disease. Intrauterine growth restriction and small for gestational age are associated with hypoglycemia and transient neonatal hyperinsulinism. Neonatal Graves disease with severe persistent hypoglycemia has not been well described. We present the case of a female patient born at 34 weeks and 3 days with a birth weight of 1.6 kg (fifth percentile) to a mother with recent treatment for Graves disease. Prenatal ultrasounds were significant for intrauterine growth restriction and small for gestational age. The mother did not begin hyperthyroidism medical therapy until 23 weeks and 2 days of gestation. After the infant was born, the infant not only had symptoms of hyperthyroidism such as tachycardia and abnormal thyroid values but also had persistent hypoglycemia, which could be due to maternal propranolol usage, prematurity, IUGR, increased metabolism due to neonatal Graves, and transient stress-induced hyperinsulinism. The infant was started on methimazole for hyperthyroidism and propranolol for tachycardia. She was also started on diazoxide for persistent hypoglycemia. By 6 months of age, the hyperthyroidism and hypoglycemia had resolved. This is an interesting case of neonatal Graves disease with severe persistent hypoglycemia which we suspect is due to transient neonatal hyperinsulinism induced by multiple stress responses.https://doi.org/10.1177/2050313X241237433 |
| spellingShingle | Samantha Fine Michael Gottschalk Krishelle Marc-Aurele Neonatal Graves disease with persistent hypoglycemia: A case report SAGE Open Medical Case Reports |
| title | Neonatal Graves disease with persistent hypoglycemia: A case report |
| title_full | Neonatal Graves disease with persistent hypoglycemia: A case report |
| title_fullStr | Neonatal Graves disease with persistent hypoglycemia: A case report |
| title_full_unstemmed | Neonatal Graves disease with persistent hypoglycemia: A case report |
| title_short | Neonatal Graves disease with persistent hypoglycemia: A case report |
| title_sort | neonatal graves disease with persistent hypoglycemia a case report |
| url | https://doi.org/10.1177/2050313X241237433 |
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