ABSTRACT
Endocrine disorders are common in infants in the neonatal ICU. They often are associated with prematurity, low birth weight or very low birth weight, and small size for gestational age. They also frequently occur in infants who are critically ill or stressed. This article describes the most common conditions and current knowledge regarding management.
Subject(s)
Endocrine System Diseases , Infant, Premature, Diseases , Metabolic Diseases , Adrenal Insufficiency/congenital , Adrenal Insufficiency/diagnosis , Adrenal Insufficiency/genetics , Adrenal Insufficiency/therapy , Endocrine System Diseases/congenital , Endocrine System Diseases/diagnosis , Endocrine System Diseases/genetics , Endocrine System Diseases/therapy , Humans , Hypocalcemia/diagnosis , Hypocalcemia/genetics , Hypocalcemia/therapy , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/genetics , Infant, Premature, Diseases/therapy , Metabolic Diseases/diagnosis , Metabolic Diseases/genetics , Metabolic Diseases/therapy , Thyroid Diseases/diagnosis , Thyroid Diseases/genetics , Thyroid Diseases/therapyABSTRACT
Endocrine disorders are common in infants in the neonatal ICU. They often are associated with prematurity, low birth weight or very low birth weight, and small size for gestational age. They also frequently occur in infants who are critically ill or stressed. This article describes the most common conditions and current knowledge regarding management.
Subject(s)
Critical Illness , Endocrine System Diseases/physiopathology , Endocrine System Diseases/therapy , Infant, Premature , Infant, Small for Gestational Age , Humans , Infant, Newborn , Infant, Newborn, Diseases/physiopathology , Infant, Newborn, Diseases/therapyABSTRACT
A 12-yr-old boy initially presented with chronic urticaria. Autoimmune thyroid disease was then diagnosed during routine evaluation. He developed type 1 diabetes shortly after thyroid hormone replacement was initiated. This case emphasizes the importance of routine screening for other autoimmune disorders in patients in whom one disorder is already present.
Subject(s)
Autoimmune Diseases/complications , Diabetes Mellitus, Type 1/etiology , Thyroid Diseases/immunology , Urticaria/complications , Autoimmune Diseases/diagnosis , Child , Humans , MaleABSTRACT
OBJECTIVES: To determine the frequency and characteristics of late rise of thyroid stimulating hormone (LRT) among ill newborns. INFANTS AND METHODS: Data were retrospectively analyzed from infants in intensive care settings with abnormal thyroid tests over 13 months. Thyroid tests were performed by filter paper if neonatal intensive care >4 weeks or serum if clinically indicated. LRT was defined as thyroid stimulating hormone (TSH) >10 microIU/ml after normal TSH on initial newborn screen. RESULTS: LRT was identified in 13 infants. Of 736 admissions to the neonatal intensive care unit (NICU), 10 (1.4%) had LRT. Excluding 3/10 with diagnosis at <1 week of age the frequency is 0.95%. Three additional cases occurred in other ICUs. TSH elevation resolved in 6/13 (group A, TSH 10.6-20.6 microIU/ml) and persisted in 7/13 necessitating treatment (group B, TSH 10.5-1326 microIU/ml). 7/13 had birth weights <1500 g. 11/13 had gestational ages <37 weeks. LRT was associated with surgery, sepsis workup, dopamine, and gastrointestinal disorders. CONCLUSIONS: LRT was not infrequent in ill newborns. Most were premature and half were not very low birth weight. We recommend monitoring of thyroid function by serum specimen in ill newborns with prolonged ICU care regardless of birth weight.
