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Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child

Background: Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children. Patient Findings: We report the case of a child with third...

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Autores principales: Zhang, Nanjun, Shao, Shuran, Yan, Yu, Hua, Yimin, Zhou, Kaiyu, Wang, Chuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230540/
https://www.ncbi.nlm.nih.gov/pubmed/34179150
http://dx.doi.org/10.3389/fcvm.2021.698089
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author Zhang, Nanjun
Shao, Shuran
Yan, Yu
Hua, Yimin
Zhou, Kaiyu
Wang, Chuan
author_facet Zhang, Nanjun
Shao, Shuran
Yan, Yu
Hua, Yimin
Zhou, Kaiyu
Wang, Chuan
author_sort Zhang, Nanjun
collection PubMed
description Background: Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children. Patient Findings: We report the case of a child with third-degree atrioventricular block, cardiogenic shock, and Adams Stokes Syndrome, who was initially misdiagnosed with fulminant myocarditis and was later found to have hypothyroidism during treatment. Summary: The child's condition did not improve after the administration of gamma globulin, methylprednisolone, and isoproterenol. Even after the placement of temporary pacemakers, the therapeutic effect was still not ideal. Upon reviewing the medical history, the child's condition improved rapidly after levothyroxine supplementation. Conclusions: Hypothyroidism is a common disease, but secondary severe cardiovascular lesions are particularly rare in children. Therefore, the delay in diagnosis can lead to serious cardiovascular manifestations. When pediatric patients develop severe AVB and bradycardia, hypothyroidism should be considered as a possible cause.
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spelling pubmed-82305402021-06-26 Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child Zhang, Nanjun Shao, Shuran Yan, Yu Hua, Yimin Zhou, Kaiyu Wang, Chuan Front Cardiovasc Med Cardiovascular Medicine Background: Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children. Patient Findings: We report the case of a child with third-degree atrioventricular block, cardiogenic shock, and Adams Stokes Syndrome, who was initially misdiagnosed with fulminant myocarditis and was later found to have hypothyroidism during treatment. Summary: The child's condition did not improve after the administration of gamma globulin, methylprednisolone, and isoproterenol. Even after the placement of temporary pacemakers, the therapeutic effect was still not ideal. Upon reviewing the medical history, the child's condition improved rapidly after levothyroxine supplementation. Conclusions: Hypothyroidism is a common disease, but secondary severe cardiovascular lesions are particularly rare in children. Therefore, the delay in diagnosis can lead to serious cardiovascular manifestations. When pediatric patients develop severe AVB and bradycardia, hypothyroidism should be considered as a possible cause. Frontiers Media S.A. 2021-06-11 /pmc/articles/PMC8230540/ /pubmed/34179150 http://dx.doi.org/10.3389/fcvm.2021.698089 Text en Copyright © 2021 Zhang, Shao, Yan, Hua, Zhou and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhang, Nanjun
Shao, Shuran
Yan, Yu
Hua, Yimin
Zhou, Kaiyu
Wang, Chuan
Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title_full Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title_fullStr Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title_full_unstemmed Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title_short Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child
title_sort case report: hypothyroidism misdiagnosed as fulminant myocarditis in a child
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230540/
https://www.ncbi.nlm.nih.gov/pubmed/34179150
http://dx.doi.org/10.3389/fcvm.2021.698089
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