| Impact of Thyrotropin Receptor Antibody Levels on Fetal Development in Two Successive Pregnancies in a Woman with Graves' Disease. | |
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MedLine Citation:
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PMID: 23154300 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Marit R Bjørgaas; Hanne Farstad; Sverre C Christiansen; Harm-Gerd K Blaas |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-14 |
Journal Detail:
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Title: Hormone research in paediatrics Volume: - ISSN: 1663-2826 ISO Abbreviation: Horm Res Paediatr Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101525157 Medline TA: Horm Res Paediatr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 S. Karger AG, Basel. |
Affiliation:
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Department of Endocrinology, St. Olavs University Hospital, Trondheim, Norway. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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