A case of Transient Neonatal Thyrotoxicosis born to mother with Graves’ Disease

2021 ◽  
Author(s):  
Adeel Musharraf ◽  
Leelavathy Kandaswamy ◽  
Senthil-Kumar Krishnasamy
Keyword(s):  
Graves Disease ◽  
Neonatal Thyrotoxicosis

scholarly journals CLINICAL CASE OF NEONATAL THYROTOXICOSIS

2018 ◽  
Vol 63 (5) ◽  
pp. 183-187
Author(s):  
M. R. Shaydullina ◽  
A. R. Shakirova ◽  
A. A. Zinatullina
Keyword(s):  
High Risk ◽  
Children And Adolescents ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Clinical Case ◽  
Heart Rhythm ◽  
The Body ◽  
Graves Disease ◽  
Intrauterine Growth ◽  
Neonatal Thyrotoxicosis

Neonatal thyrotoxicosis is 1% of all cases of thyrotoxicosis in children and adolescents and it is mostly determined by the mother’s Graves’ disease. The most dangerous manifestations of neonatal thyrotoxicosis are intrauterine growth retardation, tachycardia, and heart rhythm disturbances. Timely diagnostics and beginning of treatment are of great importance due to the high risk of fatal cardiac disruption in the acute phase of the disease and its serious consequences for the body. The article presents a clinical case of a patient with neonatal thyrotoxicosis diagnosed only at the age of 1 month, despite the mother’s burdened anamnesis; it contains a plan for diagnostic search and tactics of child management.

scholarly journals A Case of Neonatal Thyrotoxicosis with Cardiac Insufficiency

2021 ◽  
Vol 28 (4) ◽  
pp. 161-166
Author(s):  
Ji Eun Jeong ◽  
So Hee Lee ◽  
Young Hyun Kim ◽  
Yoon Young Jang ◽  
Jin-Kyung Kim
Keyword(s):  
Male Infant ◽  
Cardiac Insufficiency ◽  
Careful Examination ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Maternal Thyroid ◽  
Blocking Antibodies ◽  
Neonatal Thyrotoxicosis

Neonatal thyrotoxicosis is rare and most of the cases are secondary to maternal Graves’ disease. It is usually transient, but can be associated with significant morbidity and mortality if not recognized promptly and treated adequately. Neonates born to mothers treated with antithyroid drugs or those who receive maternal thyroid blocking antibodies may exhibit normal thyroid function or even hypothyroidism at birth. Since there may not be any obvious symptoms of hyperthyroidism at birth, it may be overlooked. Therefore, such neonates should be evaluated properly and monitored regularly to prevent serious complications of hyperthyroidism. We report a case of a 21-day-old male infant who developed thyrotoxicosis with dyspnea, irritability, tachycardia, and cardiac insufficiency. He was born to a mother who was treated for Graves’ disease with antithyroid drugs during pregnancy. We have also discussed the importance of careful examination and monitoring to prevent the development of clinical hyperthyroidism.

scholarly journals Role of Maternal Thyroid-Stimulating Immunoglobulin in Graves' Disease for Predicting Perinatal Thyroid Dysfunction

2019 ◽  
Vol 09 (04) ◽  
pp. e341-e345 ◽  
Author(s):  
Yiwen Cui ◽  
Asha Rijhsinghani
Keyword(s):  
Antithyroid Drug ◽  
Activity Level ◽  
Graves Disease ◽  
Neonatal Diagnosis ◽  
Ultrasound Findings ◽  
Thyroid Function Testing ◽  
History Of ◽  
Neonatal Thyroid Function ◽  
Maternal Thyroid ◽  
Neonatal Thyrotoxicosis

Objective To assess maternal thyroid-stimulating immunoglobulin (TSI) as a predictor of neonatal thyroid hyperthyroidism in pregnancies complicated by Graves' disease. Methods This is a 10-year retrospective study of patients with a history of Graves' disease and elevated TSI activity level defined as 1.3 times the normal. All subjects underwent cordocentesis for ultrasound findings of suspected fetal thyrotoxicosis (fetal tachycardia, oligohydramnios, hydrops, and thyromegaly). Neonatal diagnosis was made based on neonatal thyroid function testing or symptoms. Results Fourteen patients were included in the study, seven with active Graves' disease requiring antithyroid drug (“ATD group”) and seven with iatrogenic hypothyroidism on levothyroxine (“levothyroxine group”). Four cases (57%) of neonatal thyrotoxicosis were diagnosed in the levothyroxine group compared with two cases (28%) in the ATD group. The lowest maternal TSI level at which a neonate did not develop hyperthyroidism was 2.6 for the levothyroxine group and 2.5 for the ATD group. The odds ratio of a neonate from the levothyroxine group developing hyperthyroidism compared with one from the ATD group is 3.3 (95% confidence interval: 0.4–30.7). Conclusion For patients with Graves' disease, those with iatrogenic hypothyroidism and TSI > 2.5 times the basal level are at the highest risk for neonatal thyrotoxicosis.

scholarly journals Management of severe Graves’ hyperthyroidism in pregnancy following immune reconstitution therapy in multiple sclerosis

2021 ◽  
Author(s):  
Sara Salehi Hammerstad ◽  
Elisabeth G Celius ◽  
Henrik Husby ◽  
Ingvild M Sørensen ◽  
Ingrid E Norheim
Keyword(s):  
Multiple Sclerosis ◽  
Hashimoto Thyroiditis ◽  
Newborn Baby ◽  
Graves Disease ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Normal Thyroid Function ◽  
Increased Risk ◽  
Neonatal Thyrotoxicosis

Abstract Context Alemtuzumab (ALZ), a CD52 monoclonal antibody, is highly efficacious in multiple sclerosis; however, side effects are common. Autoimmune thyroid diseases (Graves’ disease and Hashimoto thyroiditis) is a well-known complication of ALZ. Treatment of ALZ induced Graves’ disease can be challenging, and even more difficult during pregnancy. Case description We present a case of severe ALZ induced Graves’ disease with a rapid increase in TSH receptor antibodies (TRAb 240 IU/L) and thyrotoxicosis in early pregnancy. Treatment with high doses of anti-thyroid medication was needed. There was high risk of both fetal and neonatal thyrotoxicosis. Serial fetal sonography showed normal development. The newborn baby presented high levels of TRAb (240 IU/L) and developed neonatal thyrotoxicosis on day eight. Adequate monitoring, treatment, and follow up of the newborn baby ensured normal thyroid function until disappearance of TRAb, 6 weeks after birth. Conclusion MS patients treated with ALZ may develop severe Graves’ disease with an increased risk of both fetal and neonatal thyrotoxicosis. Close follow up with a multidisciplinary approach is needed to ensure a healthy outcome.

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