Fetal/neonatal Thyrotoxicosis in a Newborn From a Hypothyroid Woman With Hashimoto's Thyroiditis.

Fetal/neonatal Thyrotoxicosis in a Newborn From a Hypothyroid Woman With Hashimoto's Thyroiditis.

J Clin Endocrinol Metab. 2016 Nov 4;:jc20162999

Authors: Kiefer FW, Klebermass-Schrehof K, Steiner M, Worda C, Kasprian G, Diana T, Kahaly GJ, Gessl A

Abstract
CONTEXT: Fetal/neonatal thyrotoxicosis is a rare but potentially life-threatening condition. It is most commonly observed in poorly controlled Graves' disease during pregnancy.
CASE DESCRIPTION: Here we describe the first reported case of thyrotoxicosis in a fetus/newborn from a woman with Hashimoto's thyroiditis and levothyroxine-treated hypothyroidism. Transplacental passage of stimulating TSH-receptor antibodies, measured by a cell-based bioassay, was the underlying mechanism of fetal/neonatal thyrotoxicosis even though the mother had no history of hyperthyroidism.
CONCLUSION: Diagnosis and management of fetal hyperthyroidism can be challenging. TSH receptor antibody testing should be considered in pregnant women with any history of autoimmune thyroid disease and symptoms of fetal hyperthyroidism.

PMID: 27813690 [PubMed - as supplied by publisher]

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