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Fetal and neonatal hyperthyroidism.

D Zimmerman1

  • 1Section of Pediatric Endocrinology, Mayo Clinic, Rochester, Minnesota 55905, USA. Zimmerman.donald@mayo.edu

Thyroid : Official Journal of the American Thyroid Association
|August 14, 1999
PubMed
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Fetal and neonatal hyperthyroidism, often caused by maternal Graves' disease, presents risks like growth issues and heart problems. Treatment involves maternal or neonatal medication, with persistent cases needing thyroidectomy.

Area of Science:

  • Endocrinology
  • Neonatology
  • Obstetrics

Background:

  • Fetal and neonatal hyperthyroidism typically result from transplacental passage of thyroid-stimulating immunoglobulins, commonly linked to maternal Graves' disease.
  • Antibody production can persist post-thyroid ablation or in Hashimoto's thyroiditis.
  • Other causes include McCune-Albright syndrome and activating mutations of the thyrotropin (TSH) receptor.

Purpose of the Study:

  • To review the causes, clinical manifestations, and management strategies for fetal and neonatal hyperthyroidism.
  • To highlight the potential fetal complications and neonatal symptoms associated with thyrotoxicosis.
  • To discuss the diagnostic and therapeutic approaches for both fetal and neonatal hyperthyroidism.

Main Methods:

  • Review of literature on fetal and neonatal hyperthyroidism.

Related Experiment Videos

  • Analysis of clinical features and etiological factors.
  • Summary of current treatment modalities.

    • Main Results:

    • Fetal hyperthyroidism can lead to intrauterine growth retardation, hydrops, craniosynostosis, and intrauterine death.
    • Neonatal symptoms include hyperkinesis, diarrhea, vomiting, ophthalmopathy, cardiac issues, hypertension, and hepatosplenomegaly.
    • Neonatal Graves' disease typically resolves by 48 weeks, while TSH receptor mutations may cause persistent disease.

    Conclusions:

    • Fetal hyperthyroidism management involves maternal antithyroid drug administration and fetal monitoring.
    • Neonatal hyperthyroidism treatment includes antithyroid drugs, beta-blockers, iodine, and potentially glucocorticoids or digoxin.
    • Persistent neonatal hyperthyroidism may necessitate ablative therapies like thyroidectomy.