Neonatal Thyrotoxicosis and Persistent Pulmonary Hypertension Necessitating Extracorporeal Life Support
Posted on: Friday, 21 January 2005, 03:00 CST
e105 ABSTRACT. Neonatal Thyrotoxicosis and Persistent Pulmonary Hypertension Necessitating Extracorporeal Life Support. Jon Oden, MD; and Ira M. Cheifetz, MD, FCCM. 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. Pediatrics 2005;115:e105-e108. URL: www. pediatrics.org/ cgi/doi/10.1542/peds.2004-0554; Graves' disease, persistent pulmonary hypertension of the newborn, extracorporeal life support, extracorporeal membrane oxygenation, shock, respiratory failure, neonate, hypoxia, hypotension, tachycardia, oxygen delivery, thyrotoxicosis, thyroid, hyperthyroidism.
Copyright American Academy of Pediatrics Jan 2005
Source: Pediatrics
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