Neonatal Hyperthyroidism with Fulminant Liver Failure: A Case Report

Area of Science:

• Neonatal Medicine
• Endocrinology
• Hepatology

Background:

• Neonatal hyperthyroidism is a rare condition, often associated with maternal Graves' disease.
• Hepatic manifestations of neonatal hyperthyroidism are exceptionally uncommon.

Observation:

• A neonate presented with low birth weight and hepatosplenomegaly.
• The infant developed irritability, respiratory distress, and fulminant hepatic failure within days of birth.
• Standard investigations ruled out obstructive, infectious, and metabolic causes of liver failure.

Findings:

• Liver dysfunction in the neonate showed significant improvement following the administration of carbimazole, an anti-thyroid medication.
• Conjugated hyperbilirubinemia, liver enzymes, and INR levels gradually normalized over eight weeks.
• The clinical improvement directly correlated with the initiation of anti-thyroid therapy.

Implications:

• This case highlights the importance of considering neonatal hyperthyroidism as a potential cause of cholestasis and liver failure.
• Prompt identification and treatment are vital to prevent irreversible consequences such as developmental delay or death.
• Early diagnosis and management can significantly improve outcomes for affected neonates.