Open Access
CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(03): e181-e184
DOI: 10.1055/s-0037-1606365
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Graves' Disease with Maternal Hypothyroidism

Gangaram Akangire
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Alain Cuna
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Charisse Lachica
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Ryan Fischer
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Sripriya Raman
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Venkatesh Sampath
1   Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
2   Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
› Author Affiliations
Further Information

Publication History

20 June 2017

30 July 2017

Publication Date:
22 September 2017 (online)

Preview

Abstract

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.