{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:28:44Z","timestamp":1760189324191,"version":"3.40.5"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:p>On the rare occasion when neonatal goiter is the cause of airway compromise, it typically presents with a palpable neck mass. In the setting of maternal Graves\u2019 disease (GD), fetal and neonatal goiters are most commonly caused by maternal treatment with antithyroid medication, and the goiter resolves within days of initiation of thyroxine replacement in the neonate. We describe an atypical presentation of a patient with severe neonatal GD born to a euthyroid mother at 35 weeks\u2019 gestational age with respiratory compromise, symptoms of hyperthyroidism, and a nonpalpable thyroid gland. The mother had a history of GD treated with radioactive iodine ablation; during the pregnancy she was treated with levothyroxine throughout and propylthiouracil beginning at 5 months\u2019 gestation, for fetal tachycardia. Laboratory testing after birth confirmed neonatal GD. The patient was treated with methimazole, Lugol\u2019s solution, and levothyroxine, and the patient remained euthyroid from day of life 10. After multiple extubation attempts failed, the patient was found on visualization studies to have a large, predominantly posterior, \u201cvise-like\u201d goiter encasing the larynx and upper trachea. The patient was successfully extubated, and all medications were discontinued on day of life 60. The patient remained euthyroid 1 month after discontinuation of treatment. The patient\u2019s atypical presentation illustrates the need for early neck imaging in patients with neonatal GD and respiratory distress, especially when the thyroid gland is not palpable. Treatment options for resolving a goiter due to neonatal GD are not clear.<\/jats:p>","DOI":"10.1542\/peds.2012-3000","type":"journal-article","created":{"date-parts":[[2013,9,17]],"date-time":"2013-09-17T01:09:50Z","timestamp":1379380190000},"page":"e1048-e1051","source":"Crossref","is-referenced-by-count":4,"title":["Thyroid \u201cVise\u201d in an Infant With Neonatal Graves\u2019 Disease"],"prefix":"10.1542","volume":"132","author":[{"given":"Molly O.","family":"Regelmann","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology and Diabetes, Icahn School of Medicine at Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne K.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Associates in Medicine, Pediatrics, Claremont, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Rapaport","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology and Diabetes, Icahn School of Medicine at Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"2021121006534796700_B1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1210\/jc.2007-0141","article-title":"Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline.","volume":"92","author":"Abalovich","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2021121006534796700_B2","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.1542\/peds.2009-1975F","article-title":"The impact of transient hypothyroidism on the increasing rate of congenital hypothyroidism in the United States.","volume":"125","author":"Parks","year":"2010","journal-title":"Pediatrics"},{"issue":"7","key":"2021121006534796700_B3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1089\/thy.1999.9.727","article-title":"Fetal and neonatal hyperthyroidism.","volume":"9","author":"Zimmerman","year":"1999","journal-title":"Thyroid"},{"issue":"5","key":"2021121006534796700_B4","first-page":"235","article-title":"Congenital hyperthyroidism: the fetus as a patient.","volume":"65","author":"Polak","year":"2006","journal-title":"Horm Res"},{"issue":"6","key":"2021121006534796700_B5","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1067\/mpd.2001.119447","article-title":"Neonatal thyroid enlargement associated with propylthiouracil therapy of Graves\u2019 disease during pregnancy: a problem revisited.","volume":"139","author":"Gallagher","year":"2001","journal-title":"J Pediatr"},{"issue":"11","key":"2021121006534796700_B6","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1080\/08035250600711074","article-title":"Goitrous congenital hypothyroidism in a twin pregnancy causing respiratory obstruction at birth: implications for management.","volume":"95","author":"Reynolds","year":"2006","journal-title":"Acta Paediatr"},{"issue":"3","key":"2021121006534796700_B7","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2214\/ajr.157.3.1872244","article-title":"Goitrous cretinism manifesting as newborn stridor: CT evaluation.","volume":"157","author":"Optican","year":"1991","journal-title":"AJR Am J Roentgenol"},{"key":"2021121006534796700_B8","unstructured":"Merriam-Webster Online Dictionary and Thesaurus. 2012. 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