Neonatal hyperthyroidism: neonatal clinical course of two brothers born to a mother with Graves-Basedow disease,

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A A Zuppa1, P Sindico, I Savarese

  • 1Department of Pediatrics, Division of Neonatology, Catholic University of the Sacred Heart, Rome, Italy. zuppaaa@rm.unicatt.it

Journal of Pediatric Endocrinology & Metabolism : JPEM
|June 7, 2007
PubMed

Insights

Maternal thyroidectomy can reduce but not eliminate neonatal hyperthyroidism risk. Thyroid-stimulating immunoglobulin (TSI) antibodies may persist, requiring continued infant monitoring.

Area of Science:

  • Endocrinology
  • Neonatology
  • Immunology

Background:

  • Neonatal hyperthyroidism affects 1-2% of infants born to mothers with autoimmune thyroid disease due to transplacental IgG stimulating TSH receptors (TRAb).
  • Graves' disease and Hashimoto's thyroiditis are common maternal autoimmune thyroid conditions associated with this risk.

Observation:

  • This study evaluated the impact of maternal total thyroidectomy on the neonatal clinical course.
  • Two brothers born to a mother with Graves' disease, before and after her thyroidectomy, were observed.

Findings:

  • The first infant, born before maternal thyroidectomy, exhibited persistent tachycardia, hyperthyroidism, and heart failure requiring intensive treatment.
  • The second infant, born after maternal thyroidectomy, showed laboratory hyperthyroidism and positive TRAb but only experienced weight loss, not requiring therapy.
  • Thyroid-stimulating immunoglobulin (TSI) antibodies persisted in the second infant despite the maternal thyroidectomy.

Implications:

  • Maternal thyroidectomy may lessen the severity of neonatal hyperthyroidism but does not eliminate the risk.
  • Continued clinical and instrumental follow-up of newborns is crucial, even after maternal thyroidectomy, due to potential persistent TRAb.
  • Understanding the long-term effects of transplacental antibodies is vital for managing neonatal outcomes.
Abstract

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