scholarly journals Neonatal Thyrotoxicosis with Tricuspid Valve Regurgitation and Hydrops in a Preterm Infant Born to a Mother with Graves' Disease

2018 ◽  
Vol 08 (02) ◽  
pp. e85-e88
Author(s):  
Stefani Doucette ◽  
Anne Tierney ◽  
Anne Roggensack ◽  
Kamran Yusuf
Keyword(s):  
Tricuspid Regurgitation ◽  
Tricuspid Valve Regurgitation ◽  
Grave’S Disease ◽  
First Case ◽  
Neonatal Hyperthyroidism ◽  
History Of ◽  
Grave's Disease ◽  
Thyroid Receptor ◽  
Neonatal Thyrotoxicosis ◽  
Receptor Antibodies

AbstractNeonatal hyperthyroidism is rare disorder due to the passage of thyroid receptor antibodies (TRBs) from the mother to the fetus. Neonatal thyrotoxicosis can present in several ways and if unrecognized, can be fatal. We present a preterm neonate who developed fetal hydrops and tricuspid regurgitation in utero. The mother had a history of treated Grave's disease. The infant responded to maternal treatment antenatally and postnatal anti-thyroid treatment, with resolution of both the tricuspid regurgitation and hydrops. To our knowledge, this is the first case report of tricuspid regurgitation associated with fetal and neonatal thyrotoxicosis. Our case also highlights the importance of obtaining a detailed and accurate history in a mother with previous Grave's disease, even if treated.

APPROACH TO THE PATIENT Fetal and neonatal thyroid dysfunction

2021 ◽  
Author(s):  
Juliane Léger ◽  
Clemence Delcour ◽  
Jean-Claude Carel
Keyword(s):  
Developed Countries ◽  
Antithyroid Drugs ◽  
Pituitary Hormone ◽  
Rare Disorders ◽  
Neonatal Hypothyroidism ◽  
Thyrotropin Receptor Antibodies ◽  
Neonatal Hyperthyroidism ◽  
History Of ◽  
Receptor Antibodies

Abstract Fetal and neonatal dysfunctions include rare serious disorders involving abnormal thyroid function during the second half of gestation, which may persist throughout life, as for most congenital thyroid disorders, or be transient, resolving in the first few weeks of life, as in autoimmune hyperthyroidism or hypothyroidism and some cases of congenital hypothyroidism (CH) with the thyroid gland in situ. Primary CH is diagnosed by neonatal screening, which has been implemented for 40 years in developed countries and should be introduced worldwide, as early treatment prevents irreversible neurodevelopmental delay.Central CH is a rarer entity occurring mostly in association with multiple pituitary hormone deficiencies. Other rare disorders impair the action of thyroid hormones. Neonatal Grave’s disease (GD) results from the passage of thyrotropin receptor antibodies (TRAb) across the placenta, from mother to fetus. It may affect the fetuses and neonates of mothers with a history of current or past GD, but hyperthyroidism develops only in those with high levels of stimulatory TRAb activity. The presence of antibodies predominantly blocking TSH receptors may result in transient hypothyroidism, possibly followed by neonatal hyperthyroidism, depending on the balance between the antibodies present. Antithyroid drugs taken by the mother cross the placenta, treating potential fetal hyperthyroidism,but they may also cause transient fetal and neonatal hypothyroidism. Early diagnosis and treatment are key to optimizing the child’s prognosis. This review focuses on the diagnosis and management of these patients during the fetal and neonatal periods. It includes the description of a case of fetal and neonatal autoimmune hyperthyroidism.

Hyperthyroidism in an infant of a mother with autoimmune hypothyroidism with positive TSH receptor antibodies

2018 ◽  
Vol 31 (5) ◽  
pp. 577-580 ◽  
Author(s):  
Kriti Joshi ◽  
Margaret Zacharin
Keyword(s):  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorder ◽  
Free Triiodothyronine ◽  
Autoimmune Hypothyroidism ◽  
Normal Thyroid Function ◽  
Neonatal Hyperthyroidism ◽  
History Of ◽  
Blocking Antibodies ◽  
Receptor Antibodies

Abstract Background: Neonatal hyperthyroidism is rare, seen in infants of mothers with Graves’ disease (GD), with transplacental transfer of thyroid-stimulating hormone receptor (TSHR) antibodies (TRAbs). We describe a neonate with severe hyperthyroidism due to TRAbs, born to a mother with autoimmune hypothyroidism. Case presentation: A baby boy born preterm at 35 weeks had irritability, tachycardia and proptosis after birth. The mother had autoimmune hypothyroidism, from age 10, with thyroxine replacement and normal thyroid function throughout her pregnancy. She had never been thyrotoxic. There was a family history of Hashimoto’s thyroiditis (HT) and GD. The baby’s thyroid function on day 3 demonstrated gross thyrotoxicosis, TSH<0.01 mIU/L (normal range [NR]<10 mIU/L), free thyroxine (FT4)>77 pmol/L (20–35), free triiodothyronine (FT3) 15.4 pmol/L (4.2–8.3) and TRAb 18.4 IU/L (<1.8). The mother’s TRAb was 24.7 IU/L. Thyrotoxicosis required propranolol and carbimazole (CBZ). Thyroid function normalized within 10 days. The baby was weaned off medication by 7 weeks. He remains euthyroid. Conclusions: We postulate that this mother had co-existing destructive thyroiditis and thyroid-stimulating antibodies (TSAbs) and TSHR blocking antibodies (TBAb), rendering her unable to raise a thyrotoxic response to the TSAbs but with predominant TSAb transmission to her infant. Maternal history of any thyroid disorder may increase the risk of transmission to an infant, requiring a careful clinical assessment of the neonate, with important implications for future pregnancies.

Abstract #1007: Nivolumab Induced Thyroiditis in a Patient with History of Grave’s Disease.

2017 ◽  
Vol 23 ◽  
pp. 213
Author(s):  
Geny George ◽  
Ifeoma Egbuonu ◽  
Mohini Bollineni ◽  
Nidhi Bansal
Keyword(s):  
Grave’S Disease ◽  
History Of ◽  
Grave's Disease

scholarly journals Macular Rash, Thrombocytopenia, and Hyperbilirubinemia in a Preterm Infant

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Nurin Chatur ◽  
Marina Castro ◽  
Kin Fan Young Tai
Keyword(s):  
Preterm Infant ◽  
Early Identification ◽  
Congenital Infection ◽  
Rare Condition ◽  
Graves Disease ◽  
Macular Rash ◽  
Neonatal Hyperthyroidism ◽  
Thyroid Receptor ◽  
Maternal Thyroid ◽  
Receptor Antibodies

Neonatal hyperthyroidism is usually caused by the passage of maternal thyroid receptor antibodies. This relatively rare condition has various manifestations including cholestasis, prematurity, and cardiomegaly. We present a case of a preterm infant with neonatal Graves’ disease who presented with cholestasis, cardiomegaly, and a macularpapular rash that was thought to be suspicious for congenital infection. This case has been reported to illustrate lessons learnt for early identification of a neonate with Graves’ disease in order to expedite treatment.

scholarly journals Case report: Heart failure from thyrotoxicosis due to Grave’s disease

2020 ◽  
Author(s):  
Avinash Aujayeb ◽  
James Dundas ◽  
Asgar Madathil
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Pernicious Anaemia ◽  
Thyroid Function Tests ◽  
Pleuritic Chest Pain ◽  
Grave’S Disease ◽  
History Of ◽  
Grave's Disease

Abstract A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high temperature. She was hypoxic and tachycardic and was extensively investigated as well as aggressively treated. A type 1 ‘gut feeling’ assessment by the admitting medical registrar made the diagnosis possible as thyroid function tests were grossly deranged and pointed to Grave’s disease causing heart failure, complicated by pneumonia. The patient was discharged on carbimazole, antibiotics and beta blockers. She has now been swapped onto propylthiouracil and is under active follow up

Hashimoto thyroiditis followed by Grave's disease

2014 ◽  
Author(s):  
Samia Ouldkablia ◽  
Assya Cheikh ◽  
Meriem Bensalah ◽  
Yamina Aribi ◽  
Zahra Kemali
Keyword(s):  
Hashimoto Thyroiditis ◽  
Grave’S Disease ◽  
Grave's Disease

Therapeutic options for Grave's disease and toxic nodular disease: experience of an endocrinology department

2014 ◽  
Author(s):  
Joao Silva ◽  
Mafalda Marcelino ◽  
Ana Lopes ◽  
Luis Lopes ◽  
Dolores Passos ◽  
...  
Keyword(s):  
Therapeutic Options ◽  
Grave’S Disease ◽  
Grave's Disease ◽  
Disease Experience
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