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过渡性新生儿甲状腺功能低下症随后的甲状腺功能过高症由于母体甲状腺素受体抗体
Mark Garrelfs1,2, Gerdine A Kamp3, A S Paul van Trotsenburg1,2
1Department of Pediatric Endocrinology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
JCEM case reports
|March 10, 2025
概括
孕产妇的甲状腺功能障碍会影响新生儿. 一个罕见的案例表明,来自哈西莫托病的母亲的甲状腺刺激性免疫球蛋白 (TSI) 抗体如何导致新生儿甲状腺功能低下症和甲状腺功能过高症.
科学领域:
- 内分泌学 在内分泌学.
- 新生儿科学 新生儿科学
- 免疫学 免疫学 免疫学
背景情况:
- 孕产妇甲状腺功能障碍会破坏胎儿和新生儿甲状腺激素平衡.
- 来自自身免疫性甲状腺疾病的甲状腺刺激激素受体抗体 (TRAbs) 可以穿过胎盘.
- TRAbs可以刺激或阻断TSH受体,从而影响新生儿甲状腺功能.
研究的目的:
- 描述一种罕见的过渡性新生儿甲状腺功能低下症,其次是甲状腺功能过高症的罕见病例.
- 为了研究母亲TRAbs在新生儿中发挥的作用,该新生儿的母亲患有哈西莫托病.
- 提供关于TRAbs平衡的变化及其对新生儿甲状腺功能影响的证据.
主要方法:
- 一个新生儿的病例报告,患有过渡性甲状腺功能低下症和随后的甲状腺功能升高症.
- 对母亲和新生儿甲状腺功能测试的分析.
- 在整个新生儿期内监测TRAb标位和类型.
主要成果:
- 新生儿最初表现为甲状腺功能低下,随后出现甲状腺功能过高.
- 与哈西莫托病相关的母体TRAbs与新生儿甲状腺功能障碍有关.
- 由于母亲没有接受抗甲状腺药物治疗,因此可以观察TRAb平衡的变化及其影响.
结论:
- 孕产妇的TRAbs可以导致新生儿过渡性甲状腺功能低下症和甲状腺功能升高症.
- 刺激和阻断TRAbs之间的平衡可以在出生后改变,影响新生儿甲状腺状况.
- 具有高母体TRAb标位的新生儿需要定期监测甲状腺功能,直到母体抗体被清除.
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