Abstract
Background Thymic enlargement is a common and physiological finding in children and neonates’ X-rays, but it is usually asymptomatic. Occasionally it can cause respiratory distress. In most cases the aetiology of this expansion remains unclear and it is diagnosed as a thymic hyperplasia. True thymic hyperplasia is defined as a gland expansion, both in size and weight, while maintaining normal microscopic architecture. Often it is a diagnosis of exclusion and prognosis is good.Thymic haemorrhage is an unusual condition related to high foetal and neonatal mortality.Case PresentationWe report a case of spontaneous massive thymic haemorrhage in a newborn developing at birth acute respiratory distress associated with severe bilateral haemothorax.Thymic enlargement was evident after pleural evacuation and confirmed by radiographic, Computed Tomography (CT) images and Magnetic Resonance Imaging (MRI) sequences. The spontaneous resolution of this enlargement seen with CT scan and MRI sequences suggested a thymic haemorrhage; surgery was not necessary.ConclusionThymic haemorrhage should be considered in newborn infants with pleural effusion, mediastinal space enlargement and Respiratory Distress.
Highlights
Thymic enlargement is a common and physiological finding in children and neonates’ X-rays, but it is usually asymptomatic
Thymic haemorrhage should be considered in newborn infants with pleural effusion, mediastinal space enlargement and Respiratory Distress
Several years after Urvoas et al [7] presented a case of spontaneous thymic haemorrhage in a 4-week-old boy, with good resolution after medical treatment
Summary
Respiratory Distress Syndrome is one of the most common presentations of neonatal diseases and it can be a manifestation of both pulmonary and extra-pulmonary illnesses. Thymic haemorrhage is an extremely rare condition in newborns and it is related to high foetal and neonatal mortality. It requires early diagnosis and emergency therapeutic measures in order to improve the prognosis. Abbrevations CT: computed tomography; MRI: magnetic resonance imaging; RDS: respiratory distress syndrome; NICU: Neonatal Intensive Care Unit; PT: prothrombin time; PTT: partial thromboplastin time; PLT: platelets; DIC: disseminated intravascular coagulation. Authors’ contributions GG followed the case, participated in its revision and edited the manuscript. ALP, CG and MFR carried out the clinical assessment of the case, drafted the manuscript, reviewed and edited the manuscript.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
