PO-0484 Neonatal Thyrotoxicosis With Severe Supraventricular Tachycardia: Case Report And Review Of The Literature

Background and aimsNeonatal thyrotoxicosis is a rare condition caused by the transplacental passage of thyroid stimulating immunoglobulins from mothers with Graves’ disease. We report a case of neonatal thyrotoxicosis with concurrent supraventricular tachycardia.Case ReportThe female infant, who was...

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Bibliographic Details
Published in:Archives of disease in childhood 2014-10, Vol.99 (Suppl 2), p.A406-A406
Main Authors: Abbasoglu, A, Ecevit, A, Tugcu, AU, Erdogan, I, Tulgar Kinik, S, Tarcan, A
Format: Article
Language:English
Subjects:
Amniotic fluid
Cardiac arrhythmia
Case reports
EKG
Electrocardiography
Gestation
Heart rate
Hyperthyroidism
Immunoglobulins
Iodine
Literature reviews
Meconium
Neonates
Newborn babies
Patients
Prednisolone
Pregnancy
Prenatal Care
Propranolol
Propylthiouracil
Tachycardia
Thyroid
Thyroid gland
Thyroid-stimulating hormone
Thyrotoxicosis
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Summary:Background and aimsNeonatal thyrotoxicosis is a rare condition caused by the transplacental passage of thyroid stimulating immunoglobulins from mothers with Graves’ disease. We report a case of neonatal thyrotoxicosis with concurrent supraventricular tachycardia.Case ReportThe female infant, who was born by ceasarean section due to breech delivery and meconium in the amniotic fluid at 36 weeks of gestation, presented with tachycardia on day 7. Her heart rate was between 260–300 beats/minute, and electrocardiogram revealed ongoing supraventricular tachycardia. Sotalol was effective after two cardioversions in maintaining sinus rhytm. Our patient was diagnosed to have thyroid storm due to thyrotoxicosis. Intensive medical therapy was started with 10 mg/kg/day of propylthiouracil, 1 drop of Lugol’s iodine solution three times per day, 2 mg/kg/day propranolol, and 2 mg/kg/day of oral prednisolone. After the diagnosis of neonatal thyrotoxicosis, the mother in our case was found out to have hyperthyroidism with TSH: 0.035 µIU/mL (normal: 0.35- 4.94). She was immediately started methimasole treatment.ConclusionsThe purpose of presenting this patient is to emphasise the importance of prenatal care and follow-ups. Obstetricians, endocrinologists, and paediatricians need to work together for better management of Graves’ disease associated pregnancies.
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2014-307384.1129