Graves’ Disease Complicated by Pregnancy: Malformation and Thyroid Dysfunction in Fetus Related to Maternal Disease or Its Treatment

1998 ◽  
Vol 7 (2) ◽  
pp. 73-79 ◽  
Author(s):  
Naoko Momotani
Keyword(s):  
Thyroid Dysfunction ◽  
Graves Disease ◽  
Maternal Disease

scholarly journals Prevalence and course of thyroid dysfunction in neonates at high risk of Graves’ disease or with non-autoimmune hyperthyroidism

2021 ◽  
Vol 184 (3) ◽  
pp. 431-440
Author(s):  
Hassina Benlarbi ◽  
Dominique Simon ◽  
Jonathan Rosenblatt ◽  
Cecile Dumaine ◽  
Nicolas de Roux ◽  
...  
Keyword(s):  
High Risk ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Genetic Disorder ◽  
Care Center ◽  
Receptor Gene ◽  
High Serum ◽  
Pediatric Care ◽  
Graves Disease ◽  
Neonatal Hyperthyroidism

Objective Neonatal hyperthyroidism may be caused by a permanent non-autoimmune genetic disorder or, more frequently, by maternally transmitted high serum TRAb levels. Variable thyroid dysfunction may be observed in this second context. We aimed to evaluate the prevalence of neonatal non-autoimmune hyperthyroidism and of the different types of thyroid function in neonates with a high risk of hyperthyroidism due to maternal Graves’ disease (GD). Design and methods This observational cohort study included all neonates identified in the database of a single academic pediatric care center, over a period of 13 years, as having non-autoimmune hyperthyroidism or an autoimmune disorder with high TRAb levels (above 6 IU/L) transmitted by their mothers. Patients were classified as having neonatal hyperthyroidism, hypothyroidism, or euthyroidism with a permanent or transient disorder. Results Two of the 34 consecutive neonates selected (6%) had permanent non-autoimmune hyperthyroidism due to germline (n = 1) or somatic (n = 1) mutations of the TSH receptor gene. The patients with high serum TRAb levels at birth had transient hyperthyroidism (n = 23), hypothyroidism (primary n = 2, central n = 3) or persistent euthyroidism (n = 4). Conclusion These original findings highlight the need for careful and appropriate monitoring of thyroid function in the long term, not only for the rare patients with non-autoimmune neonatal hyperthyroidism, but also for repeat monitoring during the first month of life in neonates with maternally transmitted high TRAb levels, to ensure the early identification of thyrotoxicosis in more than two thirds of cases and to detect primary or central hypothyroidism, thereby potentially decreasing associated morbidity.

Risk factors for neonatal thyroid dysfunction in pregnancies complicated by Graves’ disease

2014 ◽  
Vol 177 ◽  
pp. 89-93 ◽  
Author(s):  
Mizuki Uenaka ◽  
Kenji Tanimura ◽  
Shinya Tairaku ◽  
Ichiro Morioka ◽  
Yasuhiko Ebina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Dysfunction ◽  
Graves Disease

Different aetiologies in post-partum thyroiditis?

1983 ◽  
Vol 104 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Per Anders Dahlberg ◽  
Rolf Jansson
Keyword(s):  
Thyroid Function ◽  
Autoimmune Thyroiditis ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Lymphocytic Infiltration ◽  
Graves Disease ◽  
Thyroid Autoantibodies ◽  
Radioiodine Uptake ◽  
Thyroid Cytology

Abstract. During a 4 year period 19 women with post-partum onset of thyroid dysfunction have been seen in our clinic. Five women had high radioiodine uptake thyrotoxicosis (Graves' disease). Twelve women had hypothyroid symptoms starting within 3–6 months of delivery. All of these women had thyroid microsomal and/or cytoplasmic autoantibodies and thyroid lymphocytic infiltration suggesting aggravation of pre-existing subclinical autoimmune thyroiditis (Hashimoto's disease). At follow-up thyroid function gradually improved in all but signs of persistent thyroid hypofunction remained in seven. Thus women developing symptomatic postpartum hypothyroidism should be followed regularly and when thyroxine treatment is commenced in the post-partum period, it has to be continued indefinitely in many cases. Two women presented with transient low radioiodine uptake thyrotoxicosis and a small painless goitre. Thyroid cytology revealed thyroiditis but they had no thyroid autoantibodies. When followed after a succeeding delivery none of these women developed post-partum thyroid dysfunction in contrast to women in the autoimmune group. Probably the aetiology of thyroid dysfunction in these 2 women was different.

scholarly journals R-CHOP-Associated Graves’ Hyperthyroidism

2019 ◽  
Vol 12 (2) ◽  
pp. 581-588 ◽  
Author(s):  
Natalie Mora ◽  
Katherine N. Vu ◽  
Thanh D. Hoang ◽  
Vinh Q. Mai ◽  
Mohamed K.M. Shakir
Keyword(s):  
Thyroid Dysfunction ◽  
B Cell Lymphoma ◽  
Laboratory Evaluation ◽  
Graves Disease ◽  
Thyroid Mass ◽  
Pet Ct ◽  
Patient Reported ◽  
Persistent Fatigue ◽  
Radiation Induced ◽  
Oncologic Treatment

Radiation-induced thyroid dysfunction following oncologic treatment is not uncommon, however limited literature data has been found on patients that underwent chemotherapy only. A change in thyrometabolic autoimmune status is also a rare entity. We present a case of newly diagnosed Graves’ thyrotoxicosis following a successful R-CHOP (Rituximab, Cyclophosphamide, Doxorubicine, Vincristine and Prednisone) treatment in a patient with concurrent abdominal and thyroid diffuse large B-cell lymphoma (DLBCL). Following chemotherapy, PET CT showed resolution of FDG-avid thyroid nodule as well as no evidence of the thyroid mass on repeat ultrasound. Her thyroid function also normalized. During her follow-up visit, patient reported significant unintentional weight loss and persistent fatigue over the past couple months. Repeat laboratory evaluation revealed TSH 0.005 mIU/mL, FT4 6.73 ng/dL and thyroid stimulating immunoglobulin (TSI) 535 (ref <140%). She was started on methimazole followed by radioactive iodine therapy. This unique case of Graves’ disease following R-CHOP treatment in patients with known Hashimoto’s and thyroid lymphoma is one of the first to be reported in the literature. The swing of pendulum from Hashimoto’s to Graves’ disease is very uncommon. As clinicians, we need to continue monitoring for clinical and biochemical thyroid dysfunction in this subset of population.

scholarly journals Platelet aggregation in hypothyroidism and graves’ disease

2015 ◽  
Vol 96 (5) ◽  
pp. 742-744 ◽  
Author(s):  
M V Chepis ◽  
E S Ral’chenko ◽  
A A Klimenova ◽  
I V Ral’chenko
Keyword(s):  
Platelet Aggregation ◽  
Thyroid Dysfunction ◽  
Formation Rate ◽  
Maximum Size ◽  
Activated Partial Thromboplastin Time ◽  
Control Group ◽  
Graves Disease ◽  
Dynamic Measurements ◽  
Healthy Donors ◽  
Platelet Aggregates

Aim. To study platelet aggregation in subclinical and symptomatic hypothyroidism and Graves’ disease. Methods. The results of clinical and laboratory study of 50 patients with hypothyroidism and 20 patients with Graves’ disease are described. To access platelets aggregation function aggregatogramms were decoded by setting the maximum aggregation value; maximum aggregation rate and platelet aggregates maximum size were evaluated according to the results of the dynamic measurements on aggregometer. A control group consisted of 40 healthy donors. Results. Patients with subclinical and symptomatic hypothyroidism had prolonged activated partial thromboplastin time, reflecting the propensity for hypocoagulation, reduced total platelets number, spontaneous and ADP-induced platelet aggregation, aggregates formation rate and their maximum size. Changes were more pronounced in patients with Graves’ disease: weakening of platelet component of hemostasis, reduction of the platelets total number and the maximum size of platelet aggregates, significant reduction of the rate to reach the maximum size of platelet aggregates and platelet aggregation were observed. Conclusion. Thyroid dysfunction is accompanied by dysfunction of hemocoagulation processes, signs of chronic disseminated intravascular coagulation syndrome; these changes are clinically more severe in patients with Graves’ disease.

scholarly journals Development of Graves' Disease After SARS-CoV-2 mRNA Vaccination: A Case Report and Literature Review

2021 ◽  
Vol 9 ◽  
Author(s):  
David Tak Wai Lui ◽  
Ka Kui Lee ◽  
Chi Ho Lee ◽  
Alan Chun Hong Lee ◽  
Ivan Fan Ngai Hung ◽  
...  
Keyword(s):  
Thyroid Dysfunction ◽  
Chinese Woman ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Immunoglobulin Level ◽  
Thyroglobulin Antibodies ◽  
Old Chinese ◽  
Autoimmune Thyroid ◽  
Diffuse Goiter ◽  
History Of

Background: Mounting evidence has revealed the interrelationship between thyroid and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to explain the thyroid dysfunction and autoimmune thyroid disorders observed after coronavirus disease 2019 (COVID-19). There are limited reports of thyroid dysfunction after SARS-CoV-2 vaccination.Methods: We report a case of a 40-year-old Chinese woman who developed Graves' disease after BNT162b2 mRNA vaccine. A search of PubMed and Embase databases from 1 September 2019 to 31 August 2021 was performed using the following keywords: “COVID,” “vaccine,” “thyroid,” “thyroiditis,” and “Graves.”Results: A 40-year-old Chinese woman who had 8-year history of hypothyroidism requiring thyroxine replacement. Her anti-thyroid peroxidase and anti-thyroglobulin antibodies were negative at diagnosis. She received her first and second doses of BNT162b2 mRNA vaccine on 6 April and 1 May 2021, respectively. She developed thyrotoxicosis and was diagnosed to have Graves' disease 5 weeks after the second dose of vaccine, with positive thyroid stimulating immunoglobulin level, diffuse goiter with hypervascularity on thyroid ultrasonography and diffusely increased thyroid uptake on technetium thyroid scan. Both anti-thyroid peroxidase and anti-thyroglobulin antibodies became positive. She was treated with carbimazole. Literature search revealed four cases of Graves' disease after SARS-CoV-2 vaccination, all after mRNA vaccines; and nine cases of subacute thyroiditis, after different types of SARS-CoV-2 vaccines.Conclusion: Our case represents the fifth in the literature of Graves' disease after SARS-CoV-2 vaccination, with an unusual presentation on a longstanding history of hypothyroidism. Clinicians should remain vigilant about potential thyroid dysfunction after SARS-CoV-2 vaccination in the current pandemic.

scholarly journals Management of Graves’ Disease during Pregnancy: The Key Role of Fetal Thyroid Gland Monitoring

2005 ◽  
Vol 90 (11) ◽  
pp. 6093-6098 ◽  
Author(s):  
Dominique Luton ◽  
Isabelle Le Gac ◽  
Edith Vuillard ◽  
Mireille Castanet ◽  
Jean Guibourdenche ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Tsh Receptor ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Test Results ◽  
Bone Maturation ◽  
Normal Test ◽  
Fetal Thyroid

Abstract Background: Fetuses from mothers with Graves’ disease may experience hypothyroidism or hyperthyroidism due to transplacental transfer of antithyroid drugs (ATD) or anti-TSH receptor antibodies, respectively. Little is known about the fetal consequences. Early diagnosis is essential to successful management. We investigated a new approach to the fetal diagnosis of thyroid dysfunction and validated the usefulness of fetal thyroid ultrasonograms. Methods: Seventy-two mothers with past or present Graves’ disease and their fetuses were monitored monthly from 22 wk gestation. Fetal thyroid size and Doppler signals, and fetal bone maturation were determined on ultrasonograms, and thyroid function was evaluated at birth. Thyroid function and ATD dosage were monitored in the mothers. Results: The 31 fetuses whose mothers were anti-TSH receptor antibody negative and took no ATDs during late pregnancy had normal test results. Of the 41 other fetuses, 30 had normal test results at 32 wk, 29 were euthyroid at birth, and one had moderate hypothyroidism on cord blood tests. In the remaining 11 fetuses, goiter was visualized by ultrasonography at 32 wk, and fetal thyroid dysfunction was diagnosed and treated; there was one death, in a late referral, and 10 good outcomes with normal or slightly altered thyroid function at birth. The sensitivity and specificity of fetal thyroid ultrasound at 32 wk for the diagnosis of clinically relevant fetal thyroid dysfunction were 92 and 100%, respectively. Conclusion: In pregnant women with past or current Graves’ disease, ultrasonography of the fetal thyroid gland by an experienced ultrasonographer is an excellent diagnostic tool. This tool in conjunction with close teamwork among internists, endocrinologists, obstetricians, echographists, and pediatricians can ensure normal fetal thyroid function.

scholarly journals A case report of Graves’ disease following SARS-CoV-2 infection

2021 ◽  
Vol 8 (7) ◽  
pp. 1260
Author(s):  
John Rockett ◽  
Colbert Nelson ◽  
Robert Pierce ◽  
Amie Van Morlan
Keyword(s):  
Case Report ◽  
Patient Outcomes ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Pediatric Population ◽  
Immune Dysfunction ◽  
Graves Disease ◽  
First Case ◽  
The World ◽  
Underlying Pathology

SARS-CoV-2 pandemic has had significant impacts on the world. The longer the pandemic continues the more we learn about the virus behind it and the post-infection complications. SARS-CoV-2 infections have been associated with immune dysfunction and thyroid disease. The spectrum of thyroid disease reported spans from subacute thyroiditis to Hashimoto’s thyroiditis. We report a 16-years-old patient whose COVID-19 infection was followed by multiple complications including the appearance of symptomatic Graves’ disease. Laboratory analysis was significant for elevated TSH, low free thyroxine, and antibodies consistent with the diagnosis of Graves’ disease. This is the first case of Graves’ disease after COVID-19 infection to be reported and the first case of thyroid dysfunction secondary to COVID-19 infection reported in the pediatric population. The spectrum of thyroid and autoimmune disease following COVID-19 is discussed. Further research into the underlying pathology behind COVID-19 infection and immune dysfunction will lead to expediated diagnosis and improved patient outcomes.

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