Document Detail


Impact of Thyrotropin Receptor Antibody Levels on Fetal Development in Two Successive Pregnancies in a Woman with Graves' Disease.
MedLine Citation:
PMID:  23154300     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Treatment with radioiodine for Graves' disease regularly increases the level of antithyroid antibodies, and transplacental passage of stimulating thyrotropin receptor antibodies (TRAb) may cause fetal hyperthyroidism. Case presentation: A 21-year-old woman with Graves' disease received radioiodine treatment to avoid use of antithyroid drugs in pregnancy. She became pregnant 4 months later and was euthyroid during pregnancy. In gestational week (GW) 33, she was admitted with an increased fetal heart rate of 176-180 beats/min. Fetal echocardiography indicated cardiac decompensation. The neonate had severe hyperthyroidism (free thyroxine >100 pmol/l, nv 12.0-22.0), cardiac insufficiency, insufficient weight gain, goiter and considerably accelerated skeletal age. In the mother and neonate, TRAb was >40 IU/l (nv <1.0), indicating transplacental passage of stimulating antibodies. After delivery, TRAb remained >40 IU/l in the woman, and 18 months later she underwent total thyroidectomy with subsequent decline in TRAb. In her next pregnancy, TRAb fluctuated between 38 and 17 IU/l, and repeated fetal ultrasound showed no goiter or sign of hyperthyroidism. In cord blood, TRAb was 10.9 IU/l, and the neonate had normal thyroid hormone levels. Conclusion: This case report illustrates the impact of maternal TRAb level for neonatal outcome in two successive pregnancies.
Authors:
Marit R Bjørgaas; Hanne Farstad; Sverre C Christiansen; Harm-Gerd K Blaas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  Hormone research in paediatrics     Volume:  -     ISSN:  1663-2826     ISO Abbreviation:  Horm Res Paediatr     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101525157     Medline TA:  Horm Res Paediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Department of Endocrinology, St. Olavs University Hospital, Trondheim, Norway.
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