Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neonatal thyrotoxicosis may occur by transplacental transfer of thyroid stimulating immunoglobins from the mother. Although the clinical manifestations may vary in the new-born period, hyperthyroidism has been associated with several cardiac complications including supraventricular tachycardia, cardiomyopathy and congestive cardiac failure. We report the case of a nine day old baby who presented with severe pulmonary hypertension in association with congestive cardiac failure secondary to neonatal thyrotoxicosis. Treatment of the heart failure and restoration of the thyroid function resulted in complete regression of the pulmonary hypertension. The recognition and reversibility of pulmonary hypertension in neonatal Graves disease has not been previously described.
 ...
PMID:Reversible pulmonary hypertension in neonatal Graves disease. 926 95

Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave's disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20(th) week of pregnancy and reaches its maximum by 30(th) week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH) receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant's specific signs and symptoms.
...
PMID:Fetal and neonatal thyrotoxicosis. 2425 Dec 20