Thyroid "vise" in an infant with neonatal Graves' disease.

On the rare occasion when neonatal goiter is the cause of airway compromise, it typically presents with a palpable neck mass. In the setting of maternal Graves' disease (GD), fetal and neonatal goiters are most commonly caused by maternal treatment with antithyroid medication, and the goiter resolves within days of initiation of thyroxine replacement in the neonate. We describe an atypical presentation of a patient with severe neonatal GD born to a euthyroid mother at 35 weeks' gestational age with respiratory compromise, symptoms of hyperthyroidism, and a nonpalpable thyroid gland.