Somosri RAY, Rakesh MONDAL, Tapas SABUİ, Rupa BİSWAS

Congestive cardiac failure as a presentation of neonatal Graves in twin

Neonatal Graves is a rare entity and neonatal thyroid storm is even rarer. Graves disease is an autoimmune disorder with production of thyroid stimulating immunoglobuline (TSI) resulting in diffuse toxic goiter. Neonatal thyrotoxicosis presents with hyper-excitability, poor weight gain, tachycardia. We report a case of congestive cardiac failure with paroxysmal supraventricular tachycardia as a presentation of neonatal Graves in twin babies.

___

1. Polak M. Hyperthyroidism in early infancy:pathogenesis, clinical features and diagnosis with a focus on neonatal hyperthyroidism. Thyroid 1998; 8: 1171-1177.

2. Polak M, Legac I, Vuillard E, et al. Congenital Hyperthyroidism: The Fetus as a Patient. Horm Res 2006; 65: 235-242.

3. Dryden C, Simpson JH, Hunter LE, Jackson L. An unusual cause of neonatal coagulopathy and liver disease. J Perinatol 2007; 27: 320-322.

4. Beroukhim RS, Moon TD, Felner EI. Neonatal thyrotoxicosis and conjugated hyperbilirubinemia.J Matern Fetal Neonatal Med 2003; 13: 426-428.

5. Van der Hulst AE, Delgado V, Blom NA, et al. Cardiac resynchronization therapy in paediatric and congenital heart disease patients. Eur Heart J Sep 2011; 32: 2236-2246.

6. Wakai RT, Strasburger JF, Li Z, et al. Magnetocardiographic rhythm patterns at initiation and termination of fetal supraventricular tachycardia. Circulation 2003; 107: 307.

7. Polak M, Le Gac I, Vuillard E, et al. Fetal and neonatal thyroid function in relation to maternal Graves' disease. Best Pract Res Clin Endocrinol Metab 2004; 18: 289-302.

8. Kriplani A, Buckshee K, Bhargava VL, Takkar D, Ammini AC. Maternal and perinatal outcome in thyrotoxicosis complicating pregnancy. Eur J Obstet Gynecol Reprod Biol 1994; 54: 159-163.

9. Zakarija M, McKenzie JM, Hoffman WH. Prediction and therapy of intrauterine and late onset neonatal hyperthyroidism. J Clin Endocrinol Metab 1986; 62: 368-374.