Transient hypothyroidism associated with viral Human Parechovirus encephalitis in a newborn

Eur J Paediatr Neurol. 2015 Nov;19(6):706-10. doi: 10.1016/j.ejpn.2015.07.014. Epub 2015 Aug 14.

Abstract

Human Parechovirus type 3 (HPeV-3) is a neurotropic virus which can cause neonatal encephalitis, presenting as encephalopathy with seizures and diffuse white matter lesions on brain imaging. Neurodevelopmental outcome is linked to the extent of white matter abnormalities. We report on a neonate with clinical and biochemical findings of transient central hypothyroidism associated with HPeV-3 encephalitis. The co-occurrence of transient hypothyroidism and viral encephalitis has not been reported in newborns before. Transient suppression of the hypothalamo-pituitary-thyroidal axis is described in critically ill babies as the nonthyroidal-illness syndrome. Assessment of thyroid function in neonatal cases of HPeV-3 infection is required to conclude whether a transient hypothyroidism as in nonthyroidal-illness syndrome may be triggered by viral meningo-encephalitis and if treatment may influence neurodevelopmental outcome.

Keywords: Human Parechovirus; Hypothyroidism; Neonatal encephalopathy; Viral meningo-encephalitis; White matter lesions.

Publication types

  • Case Reports

MeSH terms

  • Brain / pathology
  • Congenital Hypothyroidism / complications*
  • Congenital Hypothyroidism / drug therapy
  • Congenital Hypothyroidism / pathology
  • Female
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Meningoencephalitis / etiology*
  • Meningoencephalitis / pathology
  • Meningoencephalitis / virology
  • Parechovirus*
  • Picornaviridae Infections / complications*
  • Picornaviridae Infections / pathology
  • Picornaviridae Infections / virology
  • Thyroid Function Tests
  • Thyroxine / therapeutic use
  • Treatment Outcome
  • White Matter / pathology

Substances

  • Thyroxine