Fetal Hyperthyroidism: Experience of Treatment in Four Siblings

Cove, D H; Johnston, Patrick G.

doi:10.1016/s0140-6736(85)91148-1

Cited by 70 publications

(28 citation statements)

References 17 publications

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“…Uncontrolled hyperthyroidism or a high TRAb value during pregnancy is a risk for low birth weight (<2500 g), prematurity and eclampsia [28]. The transplacental transfer of TSH receptor antibodies may cause intrauterine death or fetal and neonatal hyperthyroidism [7][8][9][10][11]. Mortimer et al reported that neonatal hyperthyroidism was seen in 8% (4/48) of births in women with active Graves' disease, and that maternal TRAb values exceeded 70% at delivery in all 4 births [38].…”

Section: Discussionmentioning

confidence: 99%

“…The continuation of a high (elevated) TRAb value or an increased TRAb value after surgery may cause hyperthyroidism recurrence [3,4]. In addition, previous studies demonstrated that a high TRAb value is linked to endocrine opthalmopathy [5,6], or risk for intrauterine death, and fetal or neonatal hyperthyroidism in pregnant women with Graves' disease [7][8][9][10][11][12].…”

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confidence: 99%

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Changes in Serum TSH Receptor Antibody (TRAb) Values in Patients with Graves' Disease after Total or Subtotal Thyroidectomy

et al. 2003

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Abstract. TSH receptor antibodies (TRAb) are generally regarded as mediators of thyroid stimulation in Graves' disease. In addition, a high serum TRAb value during pregnancy is one of the risk factors for intrauterine death, prematurity, and fetal or neonatal hyperthyroidism. Recently, correlations between a high serum TRAb value and endocrine opthalmopathy were also suggested. Surgical resection of the thyroid is usually followed by a reduction of serum TRAb levels in variable degrees. The relation between the extent of the thyroidectomy and the degree of reduction is still controversial. In addition, the changes in the TRAb value after total thyroidectomy (TT) over a long period of time have never been studied. We studied the changes in serum TRAb values after TT and subtotal thyroidectomy (ST) for more than 7 years. Forty-one patients with Graves' disease underwent TT, and 99 patients underwent ST. The serum TRAb values and the ratio of the patients who achieved normal values among each group (normalization rates of TRAb) at 3 and 6 months, 1, 3, 5 and 7 years after surgery were compared between the TT group and ST group. The mean preoperative TRAb values were not significantly different between the TT and ST groups, and the mean TRAb values measured 3, 6 and 12 months after surgery were not significantly different between the groups. However, the TRAb values measured 3, 5 and 7 years after surgery were significantly (p<0.05) lower in the TT group than in the ST group (16.7 ± 3.3% vs 28.0 ± 2.6%, 12.6 ± 3.4% vs 29.3 ± 3.8%, 5.6 ± 0.9% vs 25.4 ± 4.1%, respectively). The normalization rates of TRAb were not significantly different between the groups until 1 year after surgery. However, the normalization rates 3, 5 and 7 years after surgery were significantly (p<0.05) higher in the TT group than in the ST group (65.7% vs 42.4%, 77.3% vs 46.7%, 100% vs 59.1%, respectively). The surgical complication rates of TT were similar to ST except for permanent hypoparathyroidism. TT is a treatment option for Graves' disease, especially in patients with a high TRAb value who wish to have children or who have Graves' opthalmopathy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Changes in Serum TSH Receptor Antibody (TRAb) Values in Patients with Graves' Disease after Total or Subtotal Thyroidectomy

et al. 2003

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“…Neonatal transient hypothyroidism in children whose mothers have chronic thyroiditis, and neonatal thyrotoxicosis in those born to mothers with Graves' disease have been established as important disease entities in the newborn period and prompt treatments is required to prevent mental retardation in the former and, in some latter cases death due to heart failure (Cove andJohnston, 1985. Houck, et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

The Prediction of thyroid Function in Infants Born to Mothers with Chronic Thyroiditis.

et al. 1989

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“…The fetal thyroid gland begins to produce thyroid hormone by 18 to 20 weeks of gestation, 5,6 at which time the maternal TSI that crosses the placenta can stimulate thyroid hormone production. Mothers who have been treated for Graves' disease by surgical or chemical ablation of their thyroid glands, and who are euthyroid, may nevertheless have persistently elevated levels of TSI and thus bear hyperthyroid neonates.…”

Section: Discussionmentioning

confidence: 99%