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Updated: Jan 13, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Clinical features of neonatal Graves' disease revealed by twelve cases that require- antithyroid therapy
Eriko Adachi1, Ryosei Iemura2, Yumi Tanaka3
1Department of Pediatrics and Developmental Biology, Institute of Science Tokyo, Tokyo, Japan.
Insights
Maternal Graves' disease impacts neonatal Graves' disease. High maternal TRAb levels predict neonatal TRAb levels at birth, influencing treatment duration for this rare neonatal condition.
Area of Science:
- Neonatal Endocrinology
- Maternal-Fetal Medicine
Background:
- Neonatal Graves' disease (GD) is a rare but serious condition with unclear clinical features.
- Understanding its clinical course is crucial for effective management.
Purpose of the Study:
- To clarify the clinical course of neonatal GD cases requiring anti-thyroid treatment.
- To investigate the relationship between maternal and neonatal thyroid-stimulating immunoglobulin (TSI) levels and treatment duration.
Main Methods:
- Retrospective analysis of 12 neonatal GD cases (2012-2021).
- Evaluation of maternal and neonatal records, including TRAb levels, treatment regimens (Thiamazole, potassium iodide, beta-blockers), and outcomes.
- Statistical analysis to determine correlations and risk factors.
Main Results:
- All neonates had maternal GD history and elevated TRAb levels at birth.
- Maternal TRAb levels in late pregnancy significantly correlated with neonatal TRAb levels at birth (R² = 0.8454).
- Neonatal TRAb levels at birth predicted the duration of Thiamazole treatment (R² = 0.750).
- Secondary central hypothyroidism occurred in 33% of cases, with low TSH (< 0.01 μIU/mL) as a risk factor.
Conclusions:
- Maternal TRAb levels are a significant determinant of neonatal TRAb levels at birth.
- Neonatal TRAb levels can predict the required duration of anti-thyroidal therapy.
- Early identification and monitoring of neonatal GD are essential, considering potential risks like central hypothyroidism.
Abstract:
Neonatal Graves' disease (GD) is rare and serious condition with a complicated clinical course, its details of the clinical features have not been clarified. This study aimed to clarify the clinical course of neonatal GD cases requiring anti-thyroid treatment. We retrospectively analyzed records from 12 neonates (7 males) diagnosed with GD from 2012 to 2021. All neonates had maternal histories of GD, with significantly elevated TRAb levels (≥ 19 IU/L) observed during the second or third trimester of pregnancy. At birth, TRAb levels were elevated in all neonates (≥ 17.4 IU/L). Thiamazole (MMI) was given to 11 neonates, with additional potassium iodide (KI) and/or β-blockers in 10 cases; one received only KI and a β-blocker. Notably, maternal TRAb levels during late pregnancy were significantly correlated with neonatal TRAb levels at birth (R2 = 0.8454, p = 0.027), and neonatal TRAb levels at birth were significantly associated with the duration of MMI treatment (R2 = 0.750, p = 0.002). Secondary central hypothyroidism was observed in 33% of cases (4/12), with unmeasurably low TSH levels at birth (< 0.01 μIU/mL) as a significant risk factor for its development (p < 0.03). These findings suggest that maternal TRAb levels significantly influence neonatal TRAb levels at birth, and neonatal TRAb levels may predict the duration of anti-thyroidal treatment.
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