Abstract
Serial TSH and T4 determinations were performed in sixty neonates admitted to our hospital for neonatal intensive care within a period of three months. Seven patients (12%) showed transient hypothyroidism on the basis of low T4 and high TSH values. Only one of these patients, who had meconium aspiration and pneumonia, did not have the respiratory distress syndrome. In addition, 4 of these patients had sepsis. All of the patients were born before 37 gestational weeks and had birth weight under 2200 g. In addition, two patients of this gestational age and birth weight group had a progressive fall of T4 to extremely hypothyroid values without simultaneous elevation of TSH. Two of the 5 patients who died had histological studies of their thyroids. These revealed colloid-depleted vesicles, desquamated epithelium, and prominent vascularisation of the thyroid. The results of this study show that early recognition and therapy of transient hypothyroidism may be live saving.
Similar content being viewed by others
References
Aboul-Khair, S. A., Buchanan, T. J., Crooks, J., Turnbull, A. C.: Structural and functional development of the human foetal thyroid. Clin. Sci. 31 415 (1966)
Brock Jacobsen, B., Peitersen, B., Hummer, L.: Serum concentrations of thyrotropin, thyroid hormones and thyroid hormone-binding proteins during acute and recovery stages of idiopathic respiratory distress syndrome. Acta paediatr. Scand. 68, 257 (1979)
Chapman, E. M., Corner, G. W., Jr., Robinson, D., Evans, R. D.: The collection of radioactive iodine by the human fetal thyroid. J. clin. Endocrin. 8, 717 (1948)
Cuestas, R. A.: Thyroid function in healthy premature infants. J. Pediatr. 92, 963 (1978)
Cuestas, R. A., Lindall, A., Engel, R. R.: Low thyroid hormones and respiratory-distress syndrome of the newborn. N. Engl. J. Med. 295, 297 (1976)
Delange, F., Dodion, J., Wolter, R., Bourdoux, P., Dalhem, A., Glinoer, D., Ermans, A. M.: Transient hypothyroidism in the newborn infant. J. Pediatr. 92, 974 (1978)
Fisher, D. A., Hobel, C. J., Garza, R. B. S., Pierce, C. A.: Thyroid function in the preterm fetus. Pediatrics 46, 208 (1970)
Gregerman, R. I., Solomon, N.: Acceleration of thyroxine and triiodothyronine turnover during bacterial pulmonary infections and fever: implications for the functional state of the thyroid during stress and in senescence J. clin. Endocrinol. 27, 93 (1967)
Hodges, R. E., Evans, T. C., Bradbury, J. T., Keetel, W. C.: The accumulation of radioactive iodine by human fetal thyroids. J. Clin. Endocrinol. Metab. 15, 661 (1955)
Klein, A. H., Stinson, D., Foley, B., Larsen, P. R., Foley, T. P., Jr.: Thyroid function studies in preterm infants recovering from the respiratory distress, syndrome. J. Pediatr. 91, 261 (1977)
Marks, A. N., Man, E. B.: Serum butanol-extractable iodine concentrations in prematures. Pediatrics 35, 753 (1965)
Oddie, T. H., Fisher, D. H., Bernard, B., Lam, R. W.: Thyroid function at birth in infants of 30 to 45 weeks' gestation. J. Pediatr. 90, 803 (1977)
Redding, R. A., Pereira, C.: Thyroid function in respiratory distress syndrome (RDS) of the newborn. Pediatrics 54, 423 (1974)
Sagreiya, K., Emery, J. L.: Perinatal thyroid discharge. A histological study of 1225 infant thyroids. Arch. Dis. Child. 45, 746 (1970)
Uhrmann, S., Marks, K. H., Maisels, M. J., Friedman, Z., Murray, F., Kulin, H. E., Kaplan, M., Utiger, R.: Thyroid function in infants admitted to a neonatal intensive care unit (NICU)—a longitudinal assessment. Pediat. Res. 11, 432 (1977)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schönberger, W., Grimm, W., Gempp, W. et al. Transient hypothyroidism associated with prematurity, sepsis, and respiratory distress. Eur J Pediatr 132, 85–92 (1979). https://doi.org/10.1007/BF00447374
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00447374