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Neonatal Thyrotoxicosis

Journal of the Korean Pediatric Society 1966;9(5):309-312.
Published online September 30, 1966.
Neonatal Thyrotoxicosis
Bo Kyung Kim, Choon Ja Byun, Se Mo Suh
Department of Pediatric, Yonsei University Medical College.
新生兒 甲狀腺機能元進症 1 例報告
金寶鄕, 邊春子, 徐世模
延世大學校 醫科大學 小兒科擧敎室
Abstract
Since White reported the first documented case of an infant with neonatal hyperthyroidism born from a mother who had thyrotoxicosis in 1912, about 30 cases of this rare disorder have been recorded in the literature. A case of this disorder was encountered recently in the Severance Hospital, Yonsei University, for the first time in Korea. The infant was born by normal spontaneous vaginal delivery after 32 weeks gestation from a31 year old mother with hyperthyroidism on September 24, 1964. The mother was seen in this hospital for the first time on August 1963, for the enlarged thyroid gland and exophthalmos. The diagnosis of hyperthyroidism was made and 6 me of I131) were given. Nevertheless, symtoms of hyperthyroidism such as irritability and tremor of hands persisted. At birth, the infant weighed 1600 g and presented moderate exophthalmos. The thyroid glahd was slightly palpable. Respiratory rate ranged from 70 to 90/min, and pulse rate from 170 to 220/min. The skin was hyperemic. The infant was hyperactive and had a strong continous cry and ravenous appetite. He had frequent loose stools up to 11 times a day on occasions. Thyroid studies on this infant at 7 weeks of age revealed T.I. over 20ug/100 ml, P.B.I. 9.2/zg/100ml, and B.E.I. 6.5ug/ 100ml. The mother had T.I. 20.8 ug/100 ml, P.B.I. 13.2ug/100 ml, B.E.I. 10.4 ug/100 ml, and R.A.I. uptake in 48 hours 57%. He was treated with phenobarbital for the first 45 days without significant clinical improvement. On the 45th day of life, this was replaced by tapazole with good clinical improvement. The patient was discharged on November 16, 16 th, 1964 and has been doing well since.


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