Fetal Sinus Bradycardia Is Associated with Congenital Hypothyroidism: An Infant with Ectopic Thyroid Tissue
| Autor: | Ayako Seimiya, Aya Okahashi, Ichiro Morioka, Nobuhiko Nagano, Aya Nakanomori |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Bradycardia
Male endocrine system medicine.medical_specialty endocrine system diseases Sinus bradycardia Thyroid Gland Choristoma Thyroid function tests Gastroenterology General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Electrocardiography 0302 clinical medicine Fetus Internal medicine Heart rate medicine Congenital Hypothyroidism Humans 030212 general & internal medicine medicine.diagnostic_test business.industry Coronary Sinus Infant Newborn Infant Fetal Bradycardia General Medicine medicine.disease Congenital hypothyroidism Lower Extremity 030220 oncology & carcinogenesis Female medicine.symptom Thyroid function business Fetal echocardiography Neck |
| Zdroj: | The Tohoku journal of experimental medicine. 248(4) |
| ISSN: | 1349-3329 |
| Popis: | Hypothyroidism is rarely included in the differential diagnosis for fetal sinus bradycardia. We report an infant with congenital hypothyroidism caused by ectopic thyroid tissue, who showed antenatal bradycardia. The baseline fetal heart rate was 100-110 bpm at 30 weeks of gestation, and fetal echocardiography revealed sinus bradycardia but no cardiac anomalies. Maternal thyroid function was normal (thyroid-stimulating hormone [TSH] 2.03 μIU/ml, free T3 2.65 pg/ml, and free T4 0.99 ng/dl) when measured at 31 weeks of gestation. Her serum anti SS-A and SS-B antibodies, anti-thyroglobulin, and microsomal antibodies were negative. A male infant without cardiac anomalies was delivered at 35 weeks and 4 days of gestation and admitted for prematurity and respiratory distress syndrome. The infant's heart rate was 70-110 bpm (normal: 120-160 bpm) on admission. On 8 days of age, thyroid function tests revealed that the infant had severe hypothyroidism (TSH 903.3 μIU/ml, free T3 1.05 pg/ml, and free T4 0.26 ng/dl). The prolonged jaundice assumed to be due to hypothyroidism. Oral levothyroxine sodium hydrate (10 μg/kg/day) was immediately started on day 8. After the treatment, the heart rate was gradually increased to 130-140 bpm as the infant's thyroid function was improved (TSH 79.8 μIU/ml, free T3 2.95 pg/dl, and free T4 1.66 ng/dl on day 22). The infant was diagnosed ectopic thyroid tissue because of the high thyroglobulin level (85.9 μg/l). In conclusion, congenital hypothyroidism should be included in the differential diagnosis in cases of fetal bradycardia without cardiac anomalies or maternal autoimmune diseases. |
| Databáze: | OpenAIRE |
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