Congestive cardiac failure as a presentation of neonatal Graves in twin

Neonatal Graves is a rare entity and neonatal thyroid storm is even rarer. Graves disease is an autoimmune disorder with production of thyroid stimulating immunoglobuline (TSI) resulting in diffuse toxic goiter. Neonatal thyrotoxicosis presents with hyper-excitability, poor weight gain, tachycardia. We report a case of congestive cardiac failure with paroxysmal supraventricular tachycardia as a presentation of neonatal Graves in twin babies.