Florian W Kiefer1, Katrin Klebermass-Schrehof2, Manuel Steiner2, Christof Worda3, Gregor Kasprian4, Tanja Diana5, George J Kahaly5, Alois Gessl1. 1. Clinical Division of Endocrinology and Metabolism, Department of Medicine III. 2. Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics. 3. Department of Obstetrics and Gynecology. 4. Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, A-1090 Vienna, Austria; and. 5. Molecular Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, 55131 Mainz, Germany.
Abstract
Context: Fetal/neonatal thyrotoxicosis is a rare but potentially life-threatening condition. It is most commonly observed in poorly controlled Graves disease during pregnancy. Case Description: Here we describe a fetus/newborn patient with thyrotoxicosis who was born of a woman with Hashimoto thyroiditis and levothyroxine-treated hypothyroidism. Transplacental passage of stimulating thyrotropin (TSH) receptor antibodies, which were measured by a cell-based bioassay, was the underlying mechanism of fetal/neonatal thyrotoxicosis, although the mother had no history of hyperthyroidism. Conclusion: Diagnosis and management of fetal hyperthyroidism can be challenging. TSH receptor antibody testing should be considered in pregnant women with any history of autoimmune thyroid disease and symptoms of fetal hyperthyroidism.
Context:Fetal/neonatal thyrotoxicosis is a rare but potentially life-threatening condition. It is most commonly observed in poorly controlled Graves disease during pregnancy. Case Description: Here we describe a fetus/newborn patient with thyrotoxicosis who was born of a woman with Hashimoto thyroiditis and levothyroxine-treated hypothyroidism. Transplacental passage of stimulating thyrotropin (TSH) receptor antibodies, which were measured by a cell-based bioassay, was the underlying mechanism of fetal/neonatal thyrotoxicosis, although the mother had no history of hyperthyroidism. Conclusion: Diagnosis and management of fetal hyperthyroidism can be challenging. TSH receptor antibody testing should be considered in pregnant women with any history of autoimmune thyroid disease and symptoms of fetal hyperthyroidism.
Authors: Tanja Diana; Christian Wüster; Paul D Olivo; Angelica Unterrainer; Jochem König; Michael Kanitz; Artur Bossowski; Brigitte Decallonne; George J Kahaly Journal: Eur Thyroid J Date: 2017-08-08
Authors: Tanja Diana; Hans-Peter Holthoff; Julia Fassbender; Christian Wüster; Michael Kanitz; George J Kahaly; Martin Ungerer Journal: Eur Thyroid J Date: 2020-07-23