Acute neonatal collapse resulting from pericardial effusion

Two patients are described with acute collapse caused by pericardial effusion following central venous catheterisation. Echocardiography during resuscitation allowed prompt identification and management. CONCLUSION: Pericardial effusion should be considered in any baby experiencing acute deterioration with a central venous catheter in place.     

Transient neonatal hyperthyrotropinemia

The systematic screening for congenital hypothyroidism allowed to better precise the transient abnormalities of thyroid function and to interpret their mechanisms and frequency. This study analysed the transient TSH increase observed in 74 children between 1982 and 1987. Eighteen children presented with an obvious disorder, most often iodine intoxication. In 31 cases, iodine poisoning, was likely, according to history. No precise etiology could be found in 25 cases. In 7 children, L-thyroxine treatment was necessary, for various durations.     

Transient neonatal cholestasis

Due to immaturity of mechanisms involved in bile formation, the newborn is more susceptible to develop cholestasis. The causes of neonatal cholestasis are: infection, genetic and metabolic diseases, biliary atresia, and unknown or idiopathic etiologies. Most patients in whom no etiology is found are considered to belong to the group of transient neonatal cholestasis by some authors. Transient neonatal cholestasis is characterized by: early-onset cholestasis, absence of a known cause of neonatal cholestasis, normalization of clinical and biochemical parameters during follow-up, and a history of some neonatal injurious event (asphyxia, sepsis, total parenteral nutrition, etc.).     

Transient neonatal hyperthyrotropinaemia.

Of 48 consecutive newborns with elevated umbilical venous plasma thyrotropin (TSH) concentration, only two (4%) were subsequently proved to have congenital hypothyroidism, while the other 46 had transient elevation of TSH. Compared with matched controls, these 46 newborns were all delivered vaginally (P less than 0.0003) and had a longer second stage of labour (P less than 0.002), together with higher incidences of nuchal encirclement of the cord (P less than 0.05) as well as female babies (P less than 0.05). There was no difference in the incidence of antenatal complications, mean gestational age, birth weight, or birth asphyxia. There were no small-for-gestational age infants in the study group, while four were found in the controls. The results indicate that elevated umbilical cord plasma TSH concentration may represent a response to the stress of difficult or complicated delivery in the healthy appropriate- or large-for-gestational age newborn who does not have congenital hypothyroidism.     

Transient symptomatic neonatal hyperammonemia

Premature newborns suffering from respiratory distress and asphyxiated term newborns may present transient symptomatic neonatal hyperammonemia associated with reversible neonatal coma. As they survive they may develop normally; however the authors emphasize the importance of concomitant hemodynamic disorders and the extreme frequency of brain hemorrhage and ischemia. Ultrasonography or tomodensitometry are necessary for prognosis.     

Transient neonatal galactosaemia.

A 4 week old infant who failed to thrive was found to have galactose in his urine. Plasma galactose concentration was grossly raised (4.48 mmol/l; reference range less than 0.24 mmol/l) but red cell transferase and epimerase activities were normal. He improved when dietary lactose was excluded. Clinical and biochemical tolerance to galactose was evident by 7 months of age.     

Usefulness of serum thyrotropin-binding inhibitory index measurements in infantile hypothyroidism. Relationship to serum thyrotropin concentrations

Transplacental passage of thyrotropin (TSH)-binding inhibitory immunoglobulins may result in transient congenital hypothyroidism. We measured serum TSH-binding inhibitory index (TBII) in 11 infants with abnormal screening findings using a commercially available kit. Two of the infants, who were siblings, had markedly elevated TBII values (90% and 100%, respectively), as did their mother (89%, 100%), and had a clinical course consistent with transient antibody-mediated hypothyroidism. Four other infants had a borderline or mildly elevated TBII that was not present in maternal serum, suggesting that endogenous TSH was being measured in this assay. The TBII was measured in the sera of 18 additional children with primary hypothyroidism and in human TSH standards from 25 to 2000 mU/L. Increasing concentrations of TSH were associated with a linear increase in TBII. Measurement of TBII by this method may identify infants with transient antibody-mediated hypothyroidism, although simultaneous assessment of maternal serum is necessary.     

Transient and permanent neonatal diabetes

Neonatal diabetes, which may be transient or permanent, is rare. Most patients are full-term but small- for-date infants. Typical symptoms of diabetes mellitus occur within the first 4 weeks of life, requiring insulin therapy and very strict blood glucose monitoring. Subsequent growth and psychomotor development are usually normal. In about 33% of these patients the diabetes remains permanent; the transient cases, however, often develop permanent diabetes mellitus later in life. Exocrine pancreatic insufficiency is present in some patients. Neonatal diabetes differs from type-I diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction.     

Transient neonatal Behcet's disease.

A term neonate with a transient form of Behcet''s disease is described. The clinical and immunological features are detailed. As healing of the severe ulceration in this condition gives rise to scarring and cosmetic deformity recognition is important. Therapeutic intervention with corticosteroids is recommended after diagnosis.     

Transient pseudohypoparathyroidism and neonatal seizure

The case of a neonate is presented who had late onset seizure associated with hypocalcemia, hyperphosphatemia, and raised parathyroid hormone. The infant did not have any stigmata of pseudohypoparathyroidism. The hypocalcemia was initially resistant to calcium therapy, but responded to vitamin D analog therapy. The diagnosis of 'transient neonatal pseudohypoparathyroidism' was entertained, as the infant remained stable and seizure-free with normal serum biochemistry during 8 months of follow-up.     

Transient neonatal pustular melanosis.

Newborn infants were observed with vesicopustular and pigmented macular skin lesions, which occurred more commonly in black and mature infants and which were distinct clinically and histopathologically from erythema toxicum. Histopathology of skin biopsies of the vesicopustules is characterized by polymorphonuclear infiltration. The lesions often present as, or evolve into, a pigmented macule and persist from three weeks to three months. There are no associated systemic symptoms.     

Transient neonatal hair loss: a common transient neonatal dermatosis

For many years the aetiology of neonatal occipital alopecia (NOA) has been reported to be friction. We have made a retrospective check to see if the incidence of NOA has increased since the new paediatric tendencies of putting children back to sleep in the safest way have been used (APP guidelines). The results of this study in 301 neonates demonstrated that it has not. The aetiology of this phenomenon is the physiological shedding of hair in the first weeks of life. The pillow, which is often blamed, only aids this shedding. Parents should be informed that there is no relationship between the sleep position and the onset of this problem, to prevent them from changing the position of the sleeping child, which could lead to a fatal outcome.We declare that there is no potential conflict of interest, real or perceived