Universität zu Köln

Schoemig, Charlotte S., Robinson, Marie-Eve ORCID: 0000-0002-2539-227X and von Oettingen, Julia E. (2018). Treatment of congenital hypothyroidism in a newborn with malabsorption after subtotal ileum resection. Endocrinol. Diabetes Metab. Case Rep.. BRISTOL: BIOSCIENTIFICA LTD. ISSN 2052-0573

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Abstract

Congenital hypothyroidism requires prompt treatment to prevent adverse health outcomes. Poor intestinal levothyroxine absorption can complicate management. We present a case of a term female newborn with necrotizing enterocolitis (NEC) requiring subtotal ileum resection. Congenital hypothyroidism was diagnosed by newborn screening. Treatment was complicated by intestinal malabsorption of levothyroxine. Intravenous levothyroxine substitution restored euthyroidism and supraphysiologic PO doses subsequently maintained a euthyroid state. After several months, the required levothyroxine dose was weaned down to typical recommended dosing. In conclusion, small bowel resection secondary to NEC may lead to malabsorption of oral levothyroxine. An intravenous levothyroxine dose of approximately 50% typical PO dosing is effective in providing rapid normalization of free T4 and TSH. High PO doses may be required to maintain euthyroidism. Close thyroid function monitoring and immediate therapy adjustment are essential as the individual absorption may vary widely. Normal absorption levels may be regained due to adaption of the neonatal intestines.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schoemig, Charlotte S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Robinson, Marie-Eve UNSPECIFIED orcid.org/0000-0002-2539-227X UNSPECIFIED von Oettingen, Julia E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-196839
DOI:	10.1530/EDM-17-0156
Journal or Publication Title:	Endocrinol. Diabetes Metab. Case Rep.
Date:	2018
Publisher:	BIOSCIENTIFICA LTD
Place of Publication:	BRISTOL
ISSN:	2052-0573
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SHORT-BOWEL SYNDROME; NECROTIZING ENTEROCOLITIS; L-THYROXINE; TABLET FORMULATIONS; LIQUID; LEVOTHYROXINE; TSH Multiple languages Endocrinology & Metabolism Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19683