Endocrine Disorders in a Newborn with Heterozygous Galactosemia, Down Syndrome and Complex Cardiac Malformation: Case Report

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 5; p. 856
• Main Authors: Rosca, Ioana, Turenschi, Alina, Nicolescu, Alin, Constantin, Andreea Teodora, Canciu, Adina Maria, Dica, Alice Denisa, Bratila, Elvira, Coroleuca, Ciprian Andrei, Nastase, Leonard
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.04.2023; MDPI
• Subjects: Babies; Cardiac arrhythmia; Case Report; Case reports; Congenital diseases; Congenital heart disease; Defects; Diseases; Down syndrome; Down Syndrome - complications; Down Syndrome - genetics; Endocrine disorders; Endocrine System Diseases - complications; Endocrine System Diseases - diagnosis; Endocrine System Diseases - genetics; Female; Fludrocortisone; Galactose; Galactosemia; Galactosemias; Gestational age; Health aspects; Hearing Loss - diagnosis; Humans; hypoaldosteronism; Hypothyroidism; Hypoventilation; Infant; Infant, Newborn; Infants (Newborn); Intubation; Life expectancy; Metabolism; multidisciplinary team; Multidisciplinary teams; Neonatology; newborn; Newborn babies; Nosocomial infections; Patients; Pneumonia; Pulmonary arteries; Pulmonary hypertension; Thyroid hormones; Ventilators; multidisciplinary team; Down syndrome; newborn; galactosemia; hypoaldosteronism; hypothyroidism
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59050856

Down syndrome is the most common chromosomal abnormality diagnosed in newborn babies. Infants with Down syndrome have characteristic dysmorphic features and can have neuropsychiatric disorders, cardiovascular diseases, gastrointestinal abnormalities, eye problems, hearing loss, endocrine and hematologic disorders, and many other health issues. We present the case of a newborn with Down syndrome. The infant was a female, born at term through c-section. She was diagnosed before birth with a complex congenital malformation. In the first few days of life, the newborn was stable. In her 10th day of life, she started to show respiratory distress, persistent respiratory acidosis, and persistent severe hyponatremia, and required intubation and mechanical ventilation. Due to her rapid deterioration our team decided to do a screening for metabolic disorders. The screening was positive for heterozygous Duarte variant galactosemia. Further testing on possible metabolic and endocrinologic issues that can be associated with Down syndrome was performed, leading to hypoaldosteronism and hypothyroidism diagnoses. The case was challenging for our team because the infant also had multiple metabolic and hormonal deficiencies. Newborns with Down syndrome often require a multidisciplinary team, as besides congenital cardiac malformations they can have metabolic and hormonal deficiencies that can negatively impact their short- and long-term prognosis.