Abstract
IntroductionWe describe three different fetal or neonatal outcomes in the offspring of a mother who had persistent circulating thyrotropin receptor antibodies despite having undergone a total thyroidectomy several years before.Case presentationThe three different outcomes were an intrauterine death, a mild and transient fetal and neonatal hyperthyroidism and a severe fetal and neonatal hyperthyroidism that required specific therapy.ConclusionsThe three cases are interesting because of the different outcomes, the absence of a direct correlation between thyrotropin receptor antibody levels and clinical signs, and the persistence of thyrotropin receptor antibodies several years after a total thyroidectomy.
Highlights
We describe three different fetal or neonatal outcomes in the offspring of a mother who had persistent circulating thyrotropin receptor antibodies despite having undergone a total thyroidectomy several years before.Case presentation: The three different outcomes were an intrauterine death, a mild and transient fetal and neonatal hyperthyroidism and a severe fetal and neonatal hyperthyroidism that required specific therapy
Neonatal hyperthyroidism develops in about 1 to 2% of babies born to mothers suffering from Graves-Basedow disease or, in a few cases, from Hashimoto’s thyroiditis [4]
It rarely appears at birth, it is more usual within the first week of life. Sometimes it can be lethal because of the development of heart failure [3]. It is usually caused by IgG antibodies stimulating the thyroid stimulating hormone (TSH) receptors of the thyroid gland, which are called thyrotropin receptor antibodies (TRAb)
Summary
The three cases are interesting because of the different outcomes, the absence of a direct correlation between thyrotropin receptor antibody levels and clinical signs, and the persistence of thyrotropin receptor antibodies several years after a total thyroidectomy
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