由于错过新生儿查,严重的未诊断的先天性甲状腺功能低下症
Maggie Zhang1, Amirbahador Golchin1, Julia Donner2
1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
JCEM case reports
|October 9, 2025
概括
婴儿未诊断的先天性甲状腺功能低下症 (CH),新生儿查 (NBS) 错过,导致发育失败和发育迟缓. 早期的Levothyroxine治疗和多学科护理导致了显著的恢复和改善的里程碑.
科学领域:
- 儿科 儿科 儿科
- 内分泌学 在内分泌学.
- 新生儿医学 新生儿医学
背景情况:
- 先天性甲状腺功能低下症 (CH) 如果不及早诊断和治疗,可能会导致严重的发育问题.
- 新生儿查 (NBS) 对于在婴儿中识别CH至关重要.
- 家庭分娩可能会绕过标准的NBS协议,构成延迟诊断的风险.
研究的目的:
- 报告一个未被诊断的CH病例,在婴儿中呈现出不发育 (FTT) 的情况.
- 为了强调在患有CH症状的婴儿中核实NBS的重要性.
- 强调多学科护理在医疗保健管理中的作用.
主要方法:
- 一个5个月大的女婴患有FTT,低血压,发育迟缓和便秘的案例报告.
- 实验室评估显示TSH升高和无法检测的自由T4.
- 开始使用levothyroxine治疗和鼻胃管养.
- 监测甲状腺激素水平和临床进展.
主要成果:
- 利沃甲氧治疗在2周内使自由T4正常化,在5周内使TSH正常化.
- 婴儿的体重增加,运动技能和发展里程碑显著改善.
- 包括社会工作在内的多学科团队方法是护理的组成部分.
结论:
- 这一案例强调了在出现CH症状的婴儿,特别是在医院外出生的婴儿中确认NBS的关键需要.
- 及时诊断和治疗CH对于最佳的神经发育结果至关重要.
- 综合,多学科的护理显著提高了患者在CH管理的结果.
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