摘要
Abstract
Objective To analyze the clinical features and differential diagnosis of neonatal hyperbilirubinemia caused by hypothyroidism in order to reduce clinical misdiagnosis and mistreatment.Methods The clinical data of two pa-tients with neonatal hyperbilirubinemia caused by hypothyroidism who were admitted from March 2022 to July 2023 were retro-spectively analyzed.Results One patient was admitted to the hospital due to skin jaundice for 1 day after birth.After admis-sion,the three tests of hemolysis did not support neonatal ABO hemolytic jaundice,and the C-reactive protein was increased.The jaundice was preliminarily considered to be caused by infection,and blue light irradiation was given to reduce jaundice and intravenous infusion of antibiotics was administered.After treatment,the total bilirubin and inflammatory indicators of the patient basically returned to normal,but jaundice recurred and the patient was readmitted three days afterwards.The infection indicators were normal,but the three thyroid function tests were abnormal,so the recurrent pathological jaundice caused by hypothyroidism was considered.Therefore,oral administration of Levothyroxine Sodium tablets and traditional Chinese medi-cine bath treatment have shown significant effects in reducing jaundice,and the genetic testing results of jaundice in higher-level hospitals also supported the diagnosis.The misdiagnosis lasted more than 1 month.The child grew and developed well at 3-month follow-up,and jaundice did not recur.The other patient had skin jaundice on the 9th day after birth,which was ini-tially diagnosed as biological jaundice,and after treatment with blue light irradiation,the patient improved and was dis-charged.However,skin jaundice recurred at 3 days after discharge,and abnormal thyroid hormone was found by the three thyroid function tests.Therefore,the recurrent pathological jaundice caused by hypothyroidism was considered.The child was cured and discharged with a good prognosis.The misdiagnosis lasted 1 month.Conclusion There are many causes of neo-natal hyperbilirubinemia,and hyperbilirubinemia caused by hypothyroidism is rare in clinical practice.Clinicians should strengthen the understanding of the causes of this kind of jaundice,and reduce the misdiagnosis of neonatal hyperbilirubinemia caused by hypothyroidism.关键词
高胆红素血症/新生儿/误诊/感染/生理性黄疸/游离三碘甲状腺原氨酸/游离甲状腺素/促甲状腺激素Key words
Hyperbilirubinemia/Neonates/Misdiagnosis/Infection/Physiological jaundice/Free triiodothyronine/Free thyroxine/Thyroid stimulating hormone分类
临床医学
