Nationwide surveillance of circulatory collapse associated with levothyroxine administration in very‐low‐birthweight infants in Japan

Kawai, Masahiko; Kusuda, Satoshi; Cho, Kazutoshi; Horikawa, Reiko; Takizawa, Fumihiko; Ono, Masafumi; Hattori, Tetsuo; Oshiro, Makoto

doi:10.1111/j.1442-200x.2011.03518.x

Cited by 28 publications

(37 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1.9% in very low birth weight infants (Kawai et al 2012). Previously reported studies found that LCC occurred in infants with a birth weight of < 1,000 g or GA at birth of < 30 weeks, and started 2-3 weeks after birth.…”

Section: Discussionmentioning

confidence: 71%

“…This condition is termed late-onset circulatory collapse (LCC) if other causes of circulatory failure such as sepsis, patent ductus arteriosus, and hemorrhage are excluded (Nakanishi et al 2010;Kawai et al 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Levothyroxine replacement has been implicated as one of the factors that provoke LCC (Takizawa et al 2010;Yagasaki et al 2010;Kawai et al 2012). Cardiac and organ flow patterns on echography suggest distributive shock (Washio et al 2013).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Late-Onset Glucocorticoid-Responsive Circulatory Collapse in Preterm Infants: Clinical Characteristics of 14 Patients

Shimokaze

Akaba

Saito

2015

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Preterm infants may develop acute systemic hypotension that responds to glucocorticoid therapy, but not to volume loading or vasopressors, during the postnatal period. This condition is termed late-onset circulatory collapse (LCC) that develops a few weeks after birth in relatively stable infants. LCC may cause periventricular leukomalacia, periventricular necrosis in the white matter. The aim of this study was to identify the clinical characteristics of LCC. We retrospectively reviewed the clinical data of infants with LCC. Among 41 infants born at < 29 weeks of gestation between 2010 and 2014, we identified 14 infants (median gestational age 25.6 weeks) with LCC. All infants were stable before the acute onset of circulatory collapse at a median age of 21 days, which is characterized by the decreased physical activity, systolic blood pressure (12 mmHg decrease), urine output (76% decrease), and serum sodium level (4 mEq/L decrease), and the increased resistance index in the cerebral and renal arteries on Doppler ultrasonography. Both left ventricular dimension and contraction were well preserved. Three infants developed hyperkalemia. The median time from the initial hydrocortisone dose to improvements was 4 h (interquartile range 3-5 h). Hydrocortisone therapy was effective, but had to be withdrawn slowly to prevent relapse. The median duration of hydrocortisone therapy was 23 days. There was no evidence of periventricular leukomalacia in any of the infants. None of the infants developed adrenal insufficiency during the follow-up period. During the acute stage of LCC, the main priority is the early initiation of glucocorticoid therapy.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Late-Onset Glucocorticoid-Responsive Circulatory Collapse in Preterm Infants: Clinical Characteristics of 14 Patients

Shimokaze

Akaba

Saito

2015

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…A recent study from Japan also suggests that treatment of THOP may not be benign. In a nationwide case control study, the risk of circulatory collapse was higher in VLBW infants treated with L-thyroxine than in untreated controls (4.2% vs. 1.8%) [14]. This finding, along with previous concerns for an increased risk of necrotizing enterocolitis [15], warrants close attention in future interventional trials of therapy for THOP.…”

Section: Thyroid Function In Preterm Infantsmentioning

confidence: 96%

Hypothyroidism in the newborn period

Wassner

Brown

2013

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

View full text Add to dashboard Cite

Purpose of Review This review summarizes significant advances in the epidemiology, pathophysiology, and treatment of congenital hypothyroidism (CH), with a focus on thyroid dysfunction in preterm infants. Recent Findings CH appears to be increasing in incidence, primarily due to increased stringency of screening strategies, with smaller contributions from changing demographics and improved survival of increasingly premature infants. The greatest increase has been in mildly affected infants. Although many such cases are transient, some eventually prove to be severe and/or permanent. In preterm infants, transient hypothyroidism is common and may be delayed in onset. The etiology is probably multifactorial, and inadequate iodine intake may contribute to some cases. Transient hypothyroxinemia of prematurity (THOP), also common in premature infants, is correlated with markers of inflammation. Despite concern about the potential morbidity of THOP, the benefits and safety of treatment have not been established. Novel genetic causes of CH continue to be identified, and accumulating data support the sensitivity of infants with severe CH to small changes in levothyroxine formulation. Summary Changes in newborn screening strategies have increasingly identified thyroid function abnormalities of unclear clinical significance. Novel causes of CH continue to be identified, and new data continue to emerge regarding optimal therapy.

show abstract

“…LCC is usually occurred in extremely low birth weight infants (ELBWIs) and that cerebral blood flow is likely to be autoregulated above a breakpoint that averages 30 mmHg in ELBWIs. 22,23 Therefore our cut-off value may be reasonable.…”

Section: Discussionmentioning

confidence: 99%