Document Detail


Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.
MedLine Citation:
PMID:  20962435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.
Authors:
Noboru Hamada; Naoko Momotani; Naofumi Ishikawa; Jaeduk Yoshimura Noh; Yasuyuki Okamoto; Toshiaki Konishi; Koichi Ito; Kunihiko Ito
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Publication Detail:
Type:  Journal Article     Date:  2010-10-15
Journal Detail:
Title:  Endocrine journal     Volume:  58     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-04     Completed Date:  2011-05-16     Revised Date:  2011-06-16    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  55-8     Citation Subset:  IM    
Affiliation:
Sumire Hospital, Osaka Social Welfare Foundation, 1-20-85 Furuichi, Joto-ku, Osaka, Japan. hamada@sumire-hosp.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Graves Disease / blood,  radiotherapy
Humans
Hyperthyroidism / etiology*,  radiotherapy*,  surgery
Immunoglobulins, Thyroid-Stimulating / blood*
Infant, Newborn
Infant, Newborn, Diseases / etiology*
Iodine Radioisotopes / therapeutic use
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Receptors, Thyrotropin / immunology
Retrospective Studies
Risk
Chemical
Reg. No./Substance:
0/Immunoglobulins, Thyroid-Stimulating; 0/Iodine Radioisotopes; 0/Receptors, Thyrotropin; 0/thyrotropin-binding inhibitory immunoglobulin

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