Goitrous cretinism manifesting as newborn stridor: CT evaluation.

Optican, Robert J.; White, Kirk; Effmann, Eric L.

doi:10.2214/ajr.157.3.1872244

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…In addition, hypothyroidism without goiter can cause retropharyngeal soft tissue swelling [2]. However, retropharyngeal extension of the thyroid gland secondary to glandular enlargement has been described in both neonates and adults [3,4]. In the second case described above, the lateral X-ray revealed anterior bowing of the trachea by a retropharyngeal soft tissue mass (Vig.2a).…”

Section: Discussionmentioning

confidence: 99%

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Neonatal goiter: Imaging findings in two children

1996

Pediatr Radiol

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Neonatal goiter is a rare cause of a neck mass and stridor. Often, the diagnosis can be made on clinical grounds exclusively, but there may be times when a neck mass becomes a diagnostic dilemma. There are several different imaging modalities available to the clinician that are useful in the rapid diagnosis of neonatal goiter. Presently, however, there is no definite algorithm for the workup of a neonatal neck mass. The two cases presented here demonstrate the imaging findings of plain film radiography, sonography, scintigraphy, and CT in neonatal goiter.

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Section: Discussionmentioning

confidence: 99%

“…Normal thyroid has increased density on nonenhanced CT scans due to its inherent high iodine content. Normal thyroid tissue enhances vividly after contrast administration due to its rich vascular supply [3]. The child in case 2 had a conventional noncontrast CT of the neck which revealed a hyperdense mass compressing the trachea (Fig.2b).…”

Section: Discussionmentioning

confidence: 99%

Neonatal goiter: Imaging findings in two children

1996

Pediatr Radiol

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“…6 Airway compromise caused by retropharyngeal goiter has previously been described in a fullterm girl with elevated TSH and respiratory status improved 2 days after initiation of levothyroxine treatment. 7 In hypothyroidism, the lack of negative feedback to the hypothalamus and pituitary caused by low T3 and T4 leads to elevated TSH, which in turn stimulates thyroid growth and development of the goiter. Treatment with levothyroxine decreases the TSH and the stimulation of thyroid growth.…”

Section: Discussionmentioning

confidence: 99%

“…3 Neonatal goiter has been reported in association with neonatal GD, 4 and airway compromise has been described in hypothyroidism-associated neonatal goiter. [5][6][7] Reports of neonatal goiter associated with hyperthyroidism causing airway compromise are lacking.…”

Section: Introductionmentioning

confidence: 99%

Thyroid “Vise” in an Infant With Neonatal Graves’ Disease

Regelmann

Sullivan²,

Rapaport

2013

Pediatrics

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On the rare occasion when neonatal goiter is the cause of airway compromise, it typically presents with a palpable neck mass. In the setting of maternal Graves' disease (GD), fetal and neonatal goiters are most commonly caused by maternal treatment with antithyroid medication, and the goiter resolves within days of initiation of thyroxine replacement in the neonate. We describe an atypical presentation of a patient with severe neonatal GD born to a euthyroid mother at 35 weeks' gestational age with respiratory compromise, symptoms of hyperthyroidism, and a nonpalpable thyroid gland. The mother had a history of GD treated with radioactive iodine ablation; during the pregnancy she was treated with levothyroxine throughout and propylthiouracil beginning at 5 months' gestation, for fetal tachycardia. Laboratory testing after birth confirmed neonatal GD. The patient was treated with methimazole, Lugol' s solution, and levothyroxine, and the patient remained euthyroid from day of life 10. After multiple extubation attempts failed, the patient was found on visualization studies to have a large, predominantly posterior, "vise-like" goiter encasing the larynx and upper trachea. The patient was successfully extubated, and all medications were discontinued on day of life 60. The patient remained euthyroid 1 month after discontinuation of treatment. The patient' s atypical presentation illustrates the need for early neck imaging in patients with neonatal GD and respiratory distress, especially when the thyroid gland is not palpable. Treatment options for resolving a goiter due to neonatal GD are not clear.

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H

Lachman¹

2007

Taybi and Lachman's Radiology of Syndromes, Metabolic Disorders and Skeletal Dysplasias

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Goitrous cretinism manifesting as newborn stridor: CT evaluation.

Cited by 4 publications

References 2 publications

Neonatal goiter: Imaging findings in two children

Neonatal goiter: Imaging findings in two children

Thyroid “Vise” in an Infant With Neonatal Graves’ Disease

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