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Hyperthyroidism I: Introduction

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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

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Elevated thyroid-stimulating hormone level in a euthyroid neonate caused by macro thyrotropin-IgG complex.

Mariane Rix¹, Peter Laurberg, Christina Porzig

¹Department of Pediatrics, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. mariane.rix@rn.dk

Acta Paediatrica (Oslo, Norway : 1992)

|March 1, 2011

Summary

Elevated thyroid-stimulating hormone (TSH) in newborns may be caused by maternal macro-TSH, a TSH-IgG complex. This interfering factor can lead to falsely high TSH levels without affecting thyroid function, avoiding unnecessary treatment.

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Area of Science:

Endocrinology
Neonatal screening
Immunology

Background:

Neonatal screening protocols routinely measure thyroid-stimulating hormone (TSH).
Elevated TSH in newborns typically indicates congenital hypothyroidism, necessitating prompt treatment.
Interfering factors can sometimes cause falsely elevated TSH levels.

Observation:

A newborn presented with elevated TSH on routine screening, but with normal thyroxine (T4) and triiodothyronine (T3) levels.
The infant's mother also exhibited elevated serum TSH with normal thyroid hormone levels.
Further analysis revealed a TSH-immunoglobulin G (IgG) complex (macro-TSH) in both mother and infant.

Findings:

The presence of macro-TSH, a TSH-IgG complex, was identified as the cause of elevated TSH in the euthyroid neonate.
The infant's TSH normalized within 8 months as maternal IgG levels decreased.
The mother's elevated TSH persisted, suggesting a chronic condition.

Implications:

Macro-TSH should be considered in neonates with elevated TSH and normal thyroid hormone levels to prevent unnecessary treatment for hypothyroidism.
This case highlights the importance of investigating interfering factors in laboratory results.
Understanding macro-TSH is crucial for accurate diagnosis and appropriate management in neonatal endocrinology.