Neonatal thyrotoxicosis and persistent pulmonary hypertension necessitating extracorporeal life support

Jon Oden, Ira M. Cheifetz

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

We report a case of neonatal Graves' disease involving an infant with severe persistent pulmonary hypertension (PPHN) associated with neonatal thyrotoxicosis that necessitated extracorporeal membrane oxygenation. Hyperthyroidism, although uncommon in the newborn period, has been associated with pulmonary hypertension among adults. The exact mechanisms responsible for this effect on pulmonary vascular pressure are not well understood. Recent studies have provided evidence that thyrotoxicosis has direct and indirect effects on pulmonary vascular maturation, metabolism of endogenous pulmonary vasodilators, oxygen economy, vascular smooth muscle reactivity, and surfactant production, all of which may contribute to the pathophysiologic development of PPHN. Therefore, because PPHN is a significant clinical entity among term newborns and the symptoms of hyperthyroidism may be confused initially with those of other underlying disorders associated with PPHN (eg, sepsis), it would be prudent to perform screening for hyperthyroidism among affected newborns.

Original languageEnglish (US)
Pages (from-to)e105-e108
JournalPediatrics
Volume115
Issue number1
DOIs
StatePublished - Jan 1 2005

Keywords

  • Extracorporeal life support
  • Extracorporeal membrane oxygenation
  • Graves' disease
  • Hyperthyroidism
  • Hypotension
  • Hypoxia
  • Neonate
  • Oxygen delivery
  • Persistent pulmonary hypertension of the newborn
  • Respiratory failure
  • Shock
  • Tachycardia
  • Thyroid
  • Thyrotoxicosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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