Unusual course of congenital hypothyroidism and route of the L-thyroxine treatment in a preterm newborn

• Published in: Journal of clinical research in pediatric endocrinology 2014-09, Vol.6 (3), p.177-179
• Main Authors: Korkmaz, Levent, Akın, Mustafa Ali, Güneş, Tamer, Daar, Ghaniya, Baştuğ, Osman, Yıkılmaz, Ali, Kurtoğlu, Selim
• Format: Article
• Language: English
• Subjects: Administration, Oral; Biological Availability; Case Report; Cholestasis, Intrahepatic - chemically induced; Cholestasis, Intrahepatic - diagnosis; Congenital Hypothyroidism - complications; Congenital Hypothyroidism - diagnosis; Congenital Hypothyroidism - drug therapy; Gastrointestinal Diseases - etiology; Gestational Age; Hormone Replacement Therapy; Humans; Infant, Newborn; Infant, Premature; Infusions, Intravenous; Male; Thyroxine - administration & dosage; Thyroxine - adverse effects; Thyroxine - pharmacokinetics; Treatment Outcome
• ISSN: 1308-5727; 1308-5735
• DOI: 10.4274/Jcrpe.1383

Congenital hypothyroidism (CH) is the most common endocrine pathology in neonates. Inappropriate treatment of CH is complicated by irreversible brain damage or low IQ score. Hormone replacement therapy with L-thyroxine (L-T4) is sufficient for a very large proportion of patients. However, during treatment, the patient needs to be carefully monitored for presence of factors which might affect the absorption or bio-availability of the drug as well as its dose. Herein, we report a preterm newborn with CH who presented with gastrointestinal problems mimicking necrotizing enterocolitis. The clinical course was also complicated by cholestasis. The L-T4 replacement treatment was switched from oral route to parenteral. After resolution of the cholestasis, L-T4 treatment was continued successfully by the oral route.