新生儿甲状腺功能亢进症1例报道及文献复习

Neonatal hyperthyroidism: a case report and literature review

目的报道新生儿甲状腺功能亢进导致呼吸衰竭1例,并复习文献33例。方法自Medline和CNKI数据库检索国内外新生儿甲亢病例报道。结果本病例为胎龄31+2周早产儿,入院后第11天无明显诱因出现低热、心率增快、呼吸增快等,并因呼吸衰竭给予呼吸机辅助通气,实验室检查证实为甲亢。后其母亦证实为妊娠合并甲亢。33例中,心率增快、呼吸增快或体质量不增是临床表现中最多见的。结论减少对孕母甲状腺疾病漏诊率及熟练掌握新生儿甲亢的临床表现是防止临床上漏诊或误诊的关键。

Objective We report a case of neonatal thyrotoxicosis with concurrent respiratory failure in an infant born to a mother with Graves＇ disease and review the published literature describing neonatal hyperthyroidism. The male infant who was born by spontaneous delivery at 35 weeks of gestafional age presented with fever, tachycardia and tachypnea at rest on day 11 after birth, and developed severe apnea on day 14. Thyroid function studies revealed hyperthyroidism in the infant, and his mother was confirmed to have Grave＇s disease during pregnancy. Literature review showed that among the 33 infants with similar conditions, tachycardia, tachypnea and poor weight gain were the most distinct clinical features of congenital hyperthyroidism. Accurate diagnosis of Graves＇ disease in the mother during pregnancy and awareness of the clinical presentations of neonatal hyperthyroidism are key to reducing missed diagnosis or misdiagnosis of neonatal hyperthyroidism.