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Poster presentation: neonatal hypothyroidism secondary to amiodarone given for intractable supraventricular hypothyroidism. Sakethram Vijayashankar, Orhan Uzun Free

We report a neonate born via emergency caeserean sectionfor Foetal SVT with oligohydramnios and stunted growth. His mother was given flecanide and digoxin to control SVT as a fetus. Despite treatment the arrhythmia was difficult to control. A few hours after birth he had repeated episodes of SVT requiring multiple doses of adenosine. He was then placed on flecanide, propranolol and digoxin to control the SVT. However owing to persistant tachycardia amiodarone was added to control recurrent episodes of SVT. Thyroid function tests before commencing amiodarone were normal. At 4 weeks of life the patient presented to A&E on two occassions with hypothermia. Extensive investigations including for sepsis were all negative. His thyroid function at the time was indicative of subclinical hypothyroidism, hence the hypothermia was considered to be secondary to hypothyroidism. Amiodarone was promptly stopped and flecanide dose was increased to keep the SVT under control. Hypothyroidism episodes continued for about a week after stopping the amiodarone but the child has had no further episdoes of hypothermia. His thyroid functions remained abnormal for 2 months post but later on these have normalised completely. The SVT is well controlled on flecanide and propranolol with a plan to reduce their doses in a staged manner in the near future.

This is for a poster presentation only. Purpose is to make clinicians aware that Hypothermia can be a feature of Amiodarone toxicity and that we should consider it before exposing children to invasive procedures like lumbar puncture.