Congenital central hypothyroidism in a neonate born to thyrotoxic mother

Abstract

Maternal thyrotoxicosis is associated with significant risk of low birth weight premature & small for gestational age neonates; as well as intrauterine death. The abnormal thyroid functions seen in babies of thyrotoxic mothers include neonatal hyperthyroidism, transient neonatal primary hypothyroidism and transient central hypothyroidism. Transient central hypothyroidism is a unique entity which is not widely recognized. It is usually seen in neonates born from mothers with uncontrolled thyrotoxicosis. We report a case of congenital central hypothyroidism in a neonate, who born to thyrotoxic Rh negative mother. Neonate presented with anemia and prolonged cholestatic jaundice. It is important to recognize this condition timely as its delayed diagnosis & treatment results in permanent mental retardation. To avoid missing of this condition, FT4 should be monitored serially in all infants born to thyrotoxic mothers. With thyroid hormone replacement therapy there was tremendous improvement both clinically as well as biochemically in our case.