Prolonged Jaundice in the Newborn Associated with Congenital Myxedema. A Syndrome of Practical Importance

Summary The author accounts for 10 cases of congenital myxedema with simultaneous icterus neonatorum prolongatus. From his series of cases and a critical analysis of the diagnostic criteria of icterus neonatorum prolongatus, the author draws the following conclusions: (1) The simultaneous occurrence of two comparatively rare conditions, such as congenital myxedema and icterus neonatorum prolongatus of prolonged duration, makes it highly probable that this is no chance coincidence. The further nature of the relationship between these two disorders is discussed. The general inhibition of the maturing of the functions of the organs and the reduction of the rate of the metabolic processes which distinguish the newly born with deficient thyroid function, may explain why icterus neonatorum of unusually long duration can then occur. The possibility of an infectious origin, where both the thyroid gland and the liver are injured simultaneously, is also discussed. That this may occur, is shown by a case published by FRANCE, in which a virus infection simultaneously gave rise to lesions of the liver and of the thyroid gland with simultaneous jaundice and thyroid deficiency as sequelae. Such a pathogenesis was most probably not present in the cases described here. (2) The syndrome of congenital myxedema and icterus neonatorum prolongatus of marked duration is of practical significance in drawing attention to the possibility of a thyroid deficiency and thereby facilitating an early diagnosis of congenital myxedema. Icterus neonatorum prolongatus is, however, probably no constant phenomenon in congenital myxedema. (3) Icterus neonatorum prolongatus in the cases described here, appears to have been of the physiological type of jaundice However, the term physiological should not be employed unreservedly in icterus neonatorum prolongatus having a duration of 6 weeks or more.