Abstract:
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.
journal_name
Horm Res Paediatrjournal_title
Hormone research in paediatricsauthors
Bjørgaas MR,Farstad H,Christiansen SC,Blaas HGdoi
10.1159/000342644subject
Has Abstractpub_date
2013-01-01 00:00:00pages
39-43issue
1eissn
1663-2818issn
1663-2826pii
000342644journal_volume
79pub_type
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journal_title:Hormone research in paediatrics
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journal_title:Hormone research in paediatrics
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journal_title:Hormone research in paediatrics
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
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journal_title:Hormone research in paediatrics
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章
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