scholarly journals Caracterización de recién nacidos hijos de madres portadoras de enfermedad de Graves

2021 ◽  
Vol 92 (4) ◽  
pp. 556
Author(s):  
Tomás Muñoz Pérez ◽  
María Fernanda Peña Manubens ◽  
Rossana Román Reyes ◽  
Joel Riquelme Romero

El hipertiroidismo neonatal es una enfermedad que puede asociarse a mortalidad y secuelas. No existe a la fecha, una serie clínica de casos que permita conocer la realidad local de esta condición.Objetivo: Caracterizar desde el punto de vista clínico y de laboratorio a recién nacidos (RN) hijos de madres con Enfermedad de Graves (EG).Sujetos y Método: Estudio prospectivo de RN hijos de madres con antecedente de EG, en dos hospitales públicos de Santiago, por un período de 5 años. Se analizaron variables clínicas y de laboratorio de los binomios madre-hijo. Se analizaron los anticuerpos antireceptor de hormona tiroestimulante (por su acrónimo en inglés: TSH receptor antibodies, TRAbs). Se buscaron asociaciones entre estas variables y el desarrollo de hipertiroidismo neonatal.Resultados: Se incluyeron 76 binomios madre-hijo (0,2% del total de partos). Cinco neonatos (6,6%) presentaron hipertiroidismo bioquímico, y 3 de ellos desarrollaron enfermedad clínica y requirieron tratamiento. Los 5 RN que desarrollaron hipertiroidismo tenían madres con TRAbs positivos o indeterminados. Ningún hijo de madre con TRAbs negativo desarrolló la enfermedad. Sólo un 65% de las madres y un 72% de los RN pudieron tener determinación de TRAbs. Hubo una correlación significativa entre los títulos de TRAbs maternos (p < 0,03), TRAbs neonatales (p < 0,008) y la TSH neonatal tomada entre los días 2-6 (p < 0,006), con el desarrollo posterior de hipertiroidismo. Todos los casos de hipertiroidismo neonatal fueron transitorios. No hubo mortalidad en nuestra casuística.Conclusiones: En esta primera serie nacional de casos de hijos de madres con EG. Los TRAbs maternos, neonatales y la TSH entre los días 2-6 de vida fueron predictores de hipertiroidismo neonatal.

Thyroid ◽  
2007 ◽  
Vol 17 (10) ◽  
pp. 923-938 ◽  
Author(s):  
Bernard Rees Smith ◽  
Jane Sanders ◽  
Jadwiga Furmaniak

1989 ◽  
Vol 120 (1) ◽  
pp. 99-106 ◽  
Author(s):  
B. Y. Cho ◽  
Y. K. Shong ◽  
H. K. Lee ◽  
C.-S. Koh ◽  
H. K. Min

Abstract. We studied the blocking type TSH receptor antibodies in 28 patients with primary myxedema and 21 patients with goitrous Hashimoto's thyroiditis by measuring the ability of their IgGs to inhibit TSH binding to its receptor, and to inhibit TSH-stimulated cAMP increase and [3H] thymidine incorporation in a rat thyroid cell line, FRTL-5. The incidences of TSH binding inhibitor immunoglobulin, thyroid stimulation inhibiting immunoglobulin and thyroid growth inhibiting immunoglobulin in patients with primary myxedema were 54.6, 75 and 65.2%, respectively, against 14.3,0 and 17.7%, respectively, in goitrous Hashimoto's thyroiditis. The antibodies inhibited dose-dependently not only TSH stimulated but also Graves' IgG-stimulated cAMP increase and [3H] thymidine incorporation. The TSH binding inhibitor immunoglobulin activities in patients with primary myxedema were significantly correlated with both the thyroid stimulation inhibiting immunoglobulin (r = 0.665; P<0.01) and the thyroid growth inhibiting immunoglobulin (r = 0.618; P<0.01) activity. Thirteen patients whose TSH binding inhibitor immunoglobulin activities were more than 50% had both strong thyroid stimulation inhibiting immunoglobulin (75.1–100%) and thyroid growth inhibiting immunoglobulin (57.4–100%) activities. These data suggest that the vast majority of patients with primary myxedema have potent blocking type TSH receptor antibodies. These might play a role in primary myxedema causing hypothyroidism and thyroid atrophy through inhibiting TSH-stimulated cAMP generation.


1984 ◽  
Vol 105 (3) ◽  
pp. 330-340 ◽  
Author(s):  
Tjerk W. A. de Bruin ◽  
Daan van der Heide ◽  
Maria C. Krol

Abstract. The effect of the anti-TSH receptor antibodies present in the sera of 8 patients with Graves' disease on the affinity constant (Ka) and the number (R) of TSH receptors in autologous human thyroid plasma membranes was investigated. Kinetic analysis of [125I]bTSH binding to human thyroid plasma membranes in the presence of autologous Graves' and normal gammaglobulins was carried out by means of a computer fitting programme. Analysis of the TSH-TSH receptor interaction in the presence of TSH alone yielded curvilinear Scatchard plots, indicating the existence of two independent classes of binding sites (high affinity Ka: 8.5 ± 4.8 × 108 m−1; low affinity Ka: 5.3 ± 2.7 × 106 m−1). Similarly the Scatchard plot for this interaction in the presence of normal gammaglobulins is also curvilinear. Linear Scatchard plots, indicating the existence of only one class of high affinity TSH binding sites (Ka: 3.5 ± 1.8 × 108 m−1), were obtained for both autologous gammaglobulins and pure IgG from 8 patients with Graves' disease. The number of high affinity TSH binding sites in the presence of Graves' gammaglobulins had increased on the average by a factor 3.76 ± 0.74 (sd) with respect to the number found in the presence of normal gammaglobulins. This marked change in the kinetic behaviour of the TSH binding sites provided evidence that there is a direct interaction between anti-TSH receptor antibodies and autologous TSH receptors. Divalency of Graves' IgG or linkage of Fab fragments by anti-Fab antiserum proved to be necessary to produce this specific change in the kinetic behaviour of TSH binding sites. Graves' IgG monovalent Fab and Fc fragments had no effect. We suggest that the mechanism by which anti-TSH receptor antibodies in Graves' disease mimick the biological action of TSH is the IgG-induced cross-linkage of TSH receptors.


Thyrotropin ◽  
1987 ◽  
pp. 307-314 ◽  
Author(s):  
P. Vitti ◽  
G. F. Fenzi ◽  
L. Chiovato ◽  
C. Marcocci ◽  
A. Pinchera

2009 ◽  
Vol 100 (04/05) ◽  
pp. 73-74 ◽  
Author(s):  
M. Ludgate ◽  
S. Costagliola ◽  
D. Danguy ◽  
J. Perret ◽  
G. Vassart

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