Neonatal Thyrotoxicosis

Samuels, Stephanie; Namoc, Sisi M.; Bauer, Andrew J.

doi:10.1016/j.clp.2017.10.001

Cited by 36 publications

(31 citation statements)

References 30 publications

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“…20 For Samuels S and colleagues, the utility of cord blood TSH and fT4 has not been established and is not recommended. 7 Our incidence of neonatal hyperthyroidism fits the described rate of 1% to 5% of neonates born to mothers with GD. 1 The two cases with hyperthyroidism had their clinical presentation in the first two weeks, which is in line with most of the literature, but it is worth mentioning that there have been described cases as late as 45 days of life.…”

Section: Discussionsupporting

confidence: 84%

“…The lack of information led to a pregnant woman undergoing 131 I therapy, compromising the control of the disease and culminating in a case of early neonatal hyperthyroidism, when different studies advise a safety window of 6 months between 131 I therapy and pregnancy. 6,7,18 By maintaining focus on the mother's treatment, there was a decrease in the number of women on ATD during the third trimester, which is in line with the decrease of immune activity at the end of gestation. 1 The use of methimazole (MMI) during the first trimester, an arguable point, as previously mentioned, represented almost 30% of mothers and one case presented with ultrasound abnormalities (fetal growth restriction).…”

Section: Discussionmentioning

confidence: 77%

“…There is usually a continuum to the extrauterine life, with a transient picture of neonatal hyperthyroidism which can become apparent 2-5 days after birth or, rarely, 1 -2 weeks after birth. 5,7 Neonatal hyperthyroidism occurs in 2% of the offspring of mothers with GD, and although it is usually transitory, it can be life-threatening, with the need for admission to the intensive care unit. 8,9 Hypothyroidism is usually transitory, and it represents around 2% of cases of congenital hypothyroidisms.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12] Although this entity can be justified by a mutation, as it occurs in the McCune-Albright syndrome, the main cause is the transplacental passage of TRAb from mothers. 7 In order to fill this gap, the Endocrinology Section of the Portuguese Society of Pediatrics published a guideline this year focusing on the management of these offspring. 13 In this study our aims were:…”

Section: Introductionmentioning

confidence: 99%

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Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Luz¹,

Martins²,

Jerónimo³

et al. 2020

Acta Med Port

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Introduction: Graves disease is characterized by the existence of autoantibodies directed to the thyrotropin receptor, which can have a stimulatory/inhibitory action, in women with the condition, their fetus or neonate. Our aim was to review the case series of these neonates in order to establish neonatal thyroid function predictors.Material and Methods: Retrospective cohort study of the database of the Department of Pediatric Endocrinology, including patients born to mothers with Graves’ disease, between 2002 and 2017. Clinical and biochemical data were collected from mothers and offspring.Results: Fifty newborns, from 46 women with a median of 3.5 years after diagnosis, were included. During all trimesters of pregnancy, more than half of women had positive autoantibodies directed to the thyrotropin receptor. Not every woman had a complete thyroid function evaluation every trimester. In 32 newborns, cord blood screening was done. During the neonatal period, there were three cases of hypothyroidism and two of hyperthyroidism. The mothers of these five newborns had higher levels of free thyroid hormones during the second trimester (p = 0.03). The level of antibodies directed to the thyrotropin receptor was significantly higher in the cord blood (p = 0.03) and in the first neonatal test (p = 0.03) of these dysthyroid newborns.Discussion: Our results reinforce the need for every pregnant woman with Graves’ disease to be subject to thyroid function and autoantibodies evaluation during every trimester, as well as the importance of evaluating these antibodies in cord blood.Conclusion: High levels of free thyroid hormones during the second trimester of pregnancy and antibodies directed to the thyrotropin receptor value in cord blood are predictors of dysthyroidism in neonates born from women with Grave’s disease.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Luz¹,

Martins²,

Jerónimo³

et al. 2020

Acta Med Port

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“…Neonatal thyrotoxicosis might not be diagnosed by the thyroid screening program. It is recommended to test TRAb after birth, and to monitor thyroid function on days 3-5 and on day 10 [ 32 ]. On day 8, the TRAb level was 45% lower than at birth, which gradually returned to normal 6 weeks after birth, supporting the reported half-life of TRAb being 1-2 weeks [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Severe Graves’ Hyperthyroidism in Pregnancy Following Immune Reconstitution Therapy in Multiple Sclerosis

Hammerstad

Celius

Husby

et al. 2021

Journal of the Endocrine Society

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Context Alemtuzumab (ALZ), a CD52 monoclonal antibody, is highly efficacious in multiple sclerosis; however, side effects are common. Autoimmune thyroid diseases (Graves’ disease and Hashimoto thyroiditis) is a well-known complication of ALZ. Treatment of ALZ induced Graves’ disease can be challenging, and even more difficult during pregnancy. Case description We present a case of severe ALZ induced Graves’ disease with a rapid increase in TSH receptor antibodies (TRAb 240 IU/L) and thyrotoxicosis in early pregnancy. Treatment with high doses of anti-thyroid medication was needed. There was high risk of both fetal and neonatal thyrotoxicosis. Serial fetal sonography showed normal development. The newborn baby presented high levels of TRAb (240 IU/L) and developed neonatal thyrotoxicosis on day eight. Adequate monitoring, treatment, and follow up of the newborn baby ensured normal thyroid function until disappearance of TRAb, 6 weeks after birth. Conclusion MS patients treated with ALZ may develop severe Graves’ disease with an increased risk of both fetal and neonatal thyrotoxicosis. Close follow up with a multidisciplinary approach is needed to ensure a healthy outcome.

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Angeborene Schilddrüsenerkrankungen bei Neugeborenen und Kleinkindern

Krude¹,

Grüters-Kieslich²

2018

Pädiatrische Endokrinologie Und Diabetologie

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Neonatal Thyrotoxicosis

Cited by 36 publications

References 30 publications

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Neonates Born to Mothers with Graves’ Disease: 15 Year Experience of a Pediatric Endocrinology Department

Management of Severe Graves’ Hyperthyroidism in Pregnancy Following Immune Reconstitution Therapy in Multiple Sclerosis

Angeborene Schilddrüsenerkrankungen bei Neugeborenen und Kleinkindern

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