{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:16:00Z","timestamp":1789139760127,"version":"build-2803163510"},"reference-count":16,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_crpm-2026-0003_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We report an infant who presented with persistent pulmonary hypertension of the newborn (PPHN) to highlight this was likely due to congenital hypothyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_crpm-2026-0003_abs_002\">\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A male infant born at term presented with respiratory distress and hypoxia two\u202fhours after birth requiring intubation and ventilation. Due to worsening clinical condition he was transferred from the local neonatal unit to a tertiary neonatal intensive care unit (NICU) for further management. An echocardiogram showed a structurally normal heart but with reduced right ventricular function and suprasystemic pulmonary artery pressures of 80\u202fmmHg. There he required additionally inhaled nitric oxide, hydrocortisone, and intravenous fluid boluses. Sepsis was suspected as the underlying cause for the PPHN, but the infection screen was negative. He was subsequently diagnosed with congenital hypothyroidism on the newborn blood spot screening test. A technetium thyroid scan showed reduced uptake in the thyroid gland, in keeping with thyroid dyshormonogenesis. After consultation with the paediatric endocrinologists, he was commenced on levothyroxine and has made a good recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_crpm-2026-0003_abs_003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPHN and congenital hypothyroidism have rarely been reported in association with each other. Yet, thyroid hormones play a crucial role in perinatal cardiovascular adaptation, through their effects on vascular resistance, cardiac contractility and response to circulating catecholamines. This case emphasises that it is important to fully investigate an infant with apparently unexplained PPHN for rarer causes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/crpm-2026-0003","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:56:18Z","timestamp":1789138578000},"source":"Crossref","is-referenced-by-count":0,"title":["An infant with persistent pulmonary hypertension of the newborn and congenital hypothyroidism"],"prefix":"10.1515","volume":"15","author":[{"given":"Georgia Eva","family":"Fouli","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, 4th Floor Golden Jubilee Wing, King\u2019s College Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra","family":"Subba-Rao","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, 4th Floor Golden Jubilee Wing, King\u2019s College Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindra","family":"Bhat","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, 4th Floor Golden Jubilee Wing, King\u2019s College Hospital , London , UK"},{"name":"Department of Women and Children\u2019s Health , School of Life Course Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8672-5349","authenticated-orcid":false,"given":"Anne","family":"Greenough","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, 4th Floor Golden Jubilee Wing, King\u2019s College Hospital , London , UK"},{"name":"Department of Women and Children\u2019s Health , School of Life Course Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091114561336667_j_crpm-2026-0003_ref_001","unstructured":"Great Ormond Street Hospital. Persistent pulmonary hypertension of the newborn (PPHN) [Internet]; 2016. GOSH Hospital site. https:\/\/www.gosh.nhs.uk\/conditions-and-treatments\/conditions-we-treat\/persistent-pulmonary-hypertension-newborn-pphn\/ [Accessed 7 Dec 2025]."},{"key":"2026091114561336667_j_crpm-2026-0003_ref_002","doi-asserted-by":"crossref","unstructured":"Priya Cooper, JP, Budhwani, A, Kunneth, LS, Patel, IA, Omohundro, A, Sholola, OB, et al.. Persistent pulmonary hypertension of the newborn. Prog Pediatr Cardiol 2025;76:101777. https:\/\/doi.org\/10.1016\/j.ppedcard.2024.101777.","DOI":"10.1016\/j.ppedcard.2024.101777"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_003","doi-asserted-by":"crossref","unstructured":"Singh, Y, Lakshminrusimha, S. Pathophysiology and management of persistent pulmonary hypertension of the newborn. Clin Perinatol 2021;48:595\u2013618. https:\/\/doi.org\/10.1016\/j.clp.2021.05.009.","DOI":"10.1016\/j.clp.2021.05.009"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_004","doi-asserted-by":"crossref","unstructured":"Nallagonda, S, Inusa, A, Gupta, R, Nallagonda, M. Thyroid disorders in neonates: a practical approach to congenital hypothyroidism and thyrotoxicosis. Paediatr Child Health 2023;33:149\u201353. https:\/\/doi.org\/10.1016\/j.paed.2023.03.001.","DOI":"10.1016\/j.paed.2023.03.001"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_005","unstructured":"Great Ormond Street Hospital. Congenital hypothyroidism [Internet]; 2015. GOSH Hospital site. https:\/\/www.gosh.nhs.uk\/conditions-and-treatments\/conditions-we-treat\/congenital-hypothyroidism\/ [Accessed 7 Dec 2025]."},{"key":"2026091114561336667_j_crpm-2026-0003_ref_006","doi-asserted-by":"crossref","unstructured":"Klosinska, M, Kaczynska, A, Ben-Skowronek, I. Congenital hypothyroidism in preterm newborns\u00a0\u2013\u00a0the challenges of diagnostics and treatment: a review. Front Endocrinol 2022;18:13.","DOI":"10.3389\/fendo.2022.860862"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_007","unstructured":"Pilgrim, S, Stocker, M. Preterm infant with pulmonary hypertension and hypopituitarism SWISS SOCIETY OF NEONATOLOGY [Internet]; 2007. https:\/\/www.neonet.ch\/application\/files\/6615\/6628\/7303\/COTM_2007_11.pdf [Accessed 7 Dec 2025]."},{"key":"2026091114561336667_j_crpm-2026-0003_ref_008","doi-asserted-by":"crossref","unstructured":"Salerno, T, Peca, D, Menchini, L, Schiavino, A, Petreschi, F, Occasi, F, et al.. Respiratory insufficiency in a newborn with congenital hypothyroidism due to a new mutation of TTF-1\/NKX2.1 gene. Pediatr Pulmonol 2013;49:E42\u20134. https:\/\/doi.org\/10.1002\/ppul.22788.","DOI":"10.1002\/ppul.22788"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_009","doi-asserted-by":"crossref","unstructured":"Lecka-Ambroziak, A, Kot, K. Pulmonary hypertension and hypothyroidism\u00a0\u2013\u00a0still an important clinical coincidence in paediatric population, an endocrinologist\u2019s point of view. Life 2024;14:302. https:\/\/doi.org\/10.3390\/life14030302.","DOI":"10.3390\/life14030302"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_010","doi-asserted-by":"crossref","unstructured":"Lee, SY. Perinatal factors associated with neonatal thyroid-stimulating hormone in normal newborns. Ann Pediatr Endocrinol Metabol 2016;21:206. https:\/\/doi.org\/10.6065\/apem.2016.21.4.206.","DOI":"10.6065\/apem.2016.21.4.206"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_011","doi-asserted-by":"crossref","unstructured":"Kotsopoulou, I, Vyas, AK, Cory, MJ, Chan, CS, Jagarapu, J, Gill, S, et al.. Developmental changes of the fetal and neonatal thyroid gland and functional consequences on the cardiovascular system. J\u00a0Perinatol 2022;42:1576\u201386. https:\/\/doi.org\/10.1038\/s41372-022-01559-3.","DOI":"10.1038\/s41372-022-01559-3"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_012","unstructured":"Doherty, TM, Salik, I, Hu, A. Physiology, neonatal [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539840\/ [Accessed 8 Dec 2025]."},{"key":"2026091114561336667_j_crpm-2026-0003_ref_013","doi-asserted-by":"crossref","unstructured":"Breall, JA, Rudolph, AM, Heymann, MA. Role of thyroid hormone in postnatal circulatory and metabolic adjustments. J\u00a0Clin Investig 1984;73:1418\u201324. https:\/\/doi.org\/10.1172\/jci111346.","DOI":"10.1172\/JCI111346"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_014","doi-asserted-by":"crossref","unstructured":"Portman, MA. Thyroid hormone regulation of perinatal cardiovascular function. Semin Perinatol 2008;32:419\u201322. https:\/\/doi.org\/10.1053\/j.semperi.2008.09.007.","DOI":"10.1053\/j.semperi.2008.09.007"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_015","doi-asserted-by":"crossref","unstructured":"Diekman, M, Harms, M, Endert, E, Wieling, W, Wiersinga, W. Endocrine factors related to changes in total peripheral vascular resistance after treatment of thyrotoxic and hypothyroid patients. Eur J Endocrinol 2001;144:339\u201346. https:\/\/doi.org\/10.1530\/eje.0.1440339.","DOI":"10.1530\/eje.0.1440339"},{"key":"2026091114561336667_j_crpm-2026-0003_ref_016","doi-asserted-by":"crossref","unstructured":"McAllister, RM, Albarracin, I, Price, EM, Smith, TK, Turk, JR, Wyatt, KD. Thyroid status and nitric oxide in rat arterial vessels. 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