Neonatal Cholestasis Caused by Graves' Disease: A Case Report and Literature Review

This is a case report of neonatal cholestasis caused by Graves' disease, accompanied by a literature review of previously published cases. Neonatal/Infantile cholestasis (NIC) is defined as an impairment in bile formation and/or flow presenting by the first year of age, typically within the first three months. Hyperthyroidism has been less frequently associated with this condition. Here, we report a case of neonatal cholestasis caused by Graves' disease and review relevant literature to summarize its clinical characteristics, and to enhance prompt and accurate recognition and diagnosis of this disease. A 28-day-old female infant was admitted to our center, presenting with jaundice, diarrhea, poor weight gain, and tachycardia. Laboratory examinations showed cholestasis, hyperthyroidism, and positive for thyrotropin receptor antibody (TRAb), confirming the diagnosis of neonatal Graves' disease. After treatment with propranolol and intravenous immunoglobulin (IVIG), the jaundice subsided, and thyroid function returned to normal. Neonatal Graves' disease must be included in the differential diagnosis of cholestasis, particularly in infants whose mothers have Graves' disease or a history of thyroid dysfunction. Early detection of hyperthyroidism in neonates with cholestasis is crucial.