A predicted case with neonatal transient hypothyroidism due to blocking type thyrotropin binding inhibitor immunoglobulins (TBII)

Ishihara, Takashi; Waseda, Norio; Ikekubo, Katsuji; Kuroda, Kazunari; Akamizu, Takashi; Mori, Toru

doi:10.1507/endocrj1954.32.189

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…We have also studied the sera of mothers with Graves' disease in the same manner. Titration of TSH-receptor antibody activity in pregnant women with autoimmune thyroid diseases was found useful in predicting the thyroid status in their infants as previously reported concerning a small number of cases (Ishihara, et al, 1985, Arikawa, et al, 1985, Inomata, et al, 1985, Tamaki, et al, 1989.…”

supporting

confidence: 59%

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The Prediction of thyroid Function in Infants Born to Mothers with Chronic Thyroiditis.

et al. 1989

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supporting

confidence: 59%

“…1.3 to 2.1 U/ml standard TBII-serum). This (Ishihara, et al, 1985, Inomata, et al, 1986, Tamaki, et al, 1989. The 50% inhibition of TSH-induced cAMP accumulation was obtained at 3000-fold dilution in M-1 who gave birth to cases 1 and 2, but it was obtained at only 50-fold dilution in M-3 who gave birth to a euthyroid infant (Case 5).…”

Section: Discussionmentioning

confidence: 90%

The Prediction of thyroid Function in Infants Born to Mothers with Chronic Thyroiditis.

et al. 1989

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“…The transient nature of the disease in the sib¬ lings and the transient presence of serially-deter¬ mined blocking antibodies in the neonatal period, contrasting with the persistence of blocking activity in the mother, are compatible with transplacental passage of maternal antibodies as the cause of neo¬ natal hypothyroidism. The profile of the blocking antibodies correspond to a disappearance curve with a half-life estimated as 1-2 months, longer than the 11-28 days reported so far (13,17,18).…”

Section: Discussionmentioning

confidence: 49%

A case of transient hypothyroidism: Sequential serum measurements of autoantibodies inhibiting thyrotropin-stimulated thyroid cAMP production in a neonate

Rakover

Sadeh²,

Sobel³

et al. 1990

Acta Endocrinologica

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Transient neonatal hypothyroidism has been observed in three successive offspring of a mother with autoimmune thyroiditis. Thyroxine replacement therapy was initiated in a 23-year-old woman with overt clinical and laboratory findings of non-goitrous primary hypothyroidism. While on such treatment, she gave birth to three infants manifesting hypothyroidism immediately after birth. The neonates were treated with thyroxine replacement therapy which was discontinued in the three siblings at ages 2\m=1/2\ years, 3\m=1/2\ years, and 13 months. Continuous observation following cessation of therapy revealed clinical and biochemical euthyroidism in the children. Thyroid scanning during the neonatal period in the first child failed to identify functional thyroid tissue, suggesting thyroid agenesis, whereas thyroid scan performed on subsequent follow-up revealed a normal gland. Sequential serum measurements of autoantibodies directed towards the thyrotropin receptor were made in the mother and third child by a cAMP bioassay. High titres (five-six fold above normal) of blocking antibodies (tested by measuring the inhibition of TSH-stimulated cAMP production of cultured human thyroid cells by serum immunoglobulin preparations) were present in the mother and newborn 10 days after birth. The levels remained persistently high in the mother, whereas they declined and were undetectable in the child at four months. Thyroid-stimulating immunoglobulin was absent in both mother and child. The data are compatible with transient neonatal hypothyroidism caused by transplacental transfer of antibodies which block thyroid response to TSH. The half-life of the maternally-derived blocking antibody in the infant was estimated as 1-2 months. This is the first report on sequential serum measurements and estimate of half-life of the blocking antibodies performed by a cAMP bioassay (using thyroid cells of human origin). Unlike the radioreceptor assay employed so far in such cases, this assay can distinguish between stimulating and blocking TSH receptor antibodies. Transient thyroid disease may occur during the neonatal period owing to the transfer across the placenta of autoantibodies directed toward the thyrotropin receptor. The clinical manifestations in the newborn depend on the functional character¬ istics of the transferred antibody: transient neona¬ tal hyperthyroidism results from transplacental passage of thyroid-stimulating immunoglobulin (TSIg) (reviewed by Fisher (1)), whereas transfer of maternal TSH receptor blocking antibodies may cause transient hypothyroidism in the neonate (re¬ viewed by Delange (2)). The recent observation of euthyroidism, transient hyperthyroidism, and transient hypothyroidism in three children of a mother with autoimmune thyroiditis vividly dem¬ onstrate that different syndromes can occur in the newborn depending on whether stimulating or blocking antibodies predominate in the mother (3). We report here transient neonatal hypothyroidism in three successive offspring born to a mother with non-goitrous primary h...

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“…And at 15mg/ml IgG concentration, TSB activity of patient 1-M was (1980), Iseki et al (1983), Ninomiya et al (1983), Takasu et al (1984, and Ishihara et al (1985). The present family case is the sixth.…”

Section: Comparison Of Tsb Activity In Three Mothersmentioning

confidence: 52%

“…And neonatal transient hypothyroidism due to maternal blocking type TBII has been reported (Matsuura et al, 1980;Iseki et al, 1983;Ninomiya et al, 1983;Takasu et al, 1984;Ishihara et al, 1985). More recently, Arikawa et al (1985) described three neonates delivered from different three mothers with primary myxedema.…”

mentioning

confidence: 97%

Relationship between potency of blocking type thyrotropin-binding inhibitor immunoglobulin in three women with primary myxedema and thyroid function of their neonates.

et al. 1986

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Three neonates born to three mothers with primary myxedema who have thyrotropin-binding inhibitor immunoglobulin (TBII) were continually examined after birth.One neonate showed a high TSH level in mass-screening for congenital hypothyroidism and developed transient hypothyroidism.Her TBII disappeared at 114 days of age, and she remained euthyroid after discontinuation of thyroxin replacement at 146 days of age. The other two neonates were euthyroid, though they had positive TBII.In three mothers, the doses of IgGs that inhibited 125I-TSH binding to the level of 50% were compared. The potency of IgG from the mother whose neonate developed hypothyroidism was stronger than that of IgG from the other two mothers. And the elevation of cAMP induced by bovine TSH in suspension culture with porcine thyroid follicles was significantly reduced in the presence of IgG from the three mothers when compared with normal IgG. The thyroid-stimulation blocking activity was more potent in the mother whose neonate developed hypothyroidism than in the other two mothers. This study suggests that the thyroid function of neonates born to primary myxedema with blocking type TBII is influenced by the potency of TSH-binding inhibitor and thyroid-stimulation blocking activity of the mother.

show abstract

A predicted case with neonatal transient hypothyroidism due to blocking type thyrotropin binding inhibitor immunoglobulins (TBII)

Cited by 14 publications

References 14 publications

The Prediction of thyroid Function in Infants Born to Mothers with Chronic Thyroiditis.

The Prediction of thyroid Function in Infants Born to Mothers with Chronic Thyroiditis.

A case of transient hypothyroidism: Sequential serum measurements of autoantibodies inhibiting thyrotropin-stimulated thyroid cAMP production in a neonate

Relationship between potency of blocking type thyrotropin-binding inhibitor immunoglobulin in three women with primary myxedema and thyroid function of their neonates.

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