Biochemical investigation of foetal and neonatal thyroid function using the ACS-180SE analyser: clinical application

Gadrey, Jean; Noël, Michèle; Chevenne, Didier; Vuillard, E.; Voluménie, Jean Luc; Polak, Michel; Boissinot, C.; Porquet, Dominique; Luton, Dominique

doi:10.1258/0004563011901334

Cited by 13 publications

(9 citation statements)

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“…Fetal growth parameters were measured, and fetal heart rate was recorded and considered normal if between 120 and 150 bpm. Fetal bone maturation (distal femoral ossification center) and thyroid gland size were evaluated whenever possible as previously published [9]. …”

Section: Methodsmentioning

confidence: 99%

“…Maternal blood contamination was ruled out by measuring the total human chorionic gonadotropin (hCG) level using the ACS-180 SE analyzer. Serum thyrotropin (TSH) and free thyroxine (FT4) levels were determined using the chemiluminescent immunoassay analyzers Advia Centaur XP and ACS-180 SE, respectively [9]. hCG was concomitantly measured to rule out any maternal contamination, and there was no cross-reactivity between TSH and hCG.…”

Section: Methodsmentioning

confidence: 99%

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Thyroid Function in Fetuses with Down Syndrome

Luton

Azria

Polak³

et al. 2012

Horm Res Paediatr

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Background/Aims: A mild increase in thyrotropin (thyroid-stimulating hormone; TSH) is common among Down syndrome patients but is rarely detected by neonatal screening at birth. We hypothesized that Down syndrome was associated with fetal hypothyroidism and tried to determine whether Down syndrome fetuses had evidence of hypothyroidism. Methods: We performed a prospective observational study on 13 fetuses with Down syndrome diagnosed prenatally. TSH and free thyroxine (FT4) levels were measured in fetal blood. The results were analyzed and compared with the findings from fetal sonography and histopathology. Results: Of the 13 fetuses, 6 had TSH values greater than the 95th percentile, and FT4 values were low. None of the fetuses had sonographic evidence of goiter. The thyroids were normal by gross examination but exhibited small follicles and histological features suggesting delayed maturation. Conclusion: The absence of goiter even in fetuses with hyperthyrotropinemia suggests a mild decrease in TSH responsiveness.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Thyroid Function in Fetuses with Down Syndrome

Luton

Azria

Polak³

et al. 2012

Horm Res Paediatr

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“…The mean age of the studied group of 77 pregnant women was 30.9 years (range: [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Sixty one patients presented with hyperthyroidism: gestational hyperthyroidism (n = 35) or Graves' disease (n = 26).…”

Section: Resultsmentioning

confidence: 99%

“…Reference ranges for the analysed parameters were as follows: TSH 0.4-4.0 mIU/mL, fT4 10.4-24.4 pmol/L, fT3 1.8-4.2 pg/mL, TPOAbs < 35 IU/mL, TGAbs < 40 IU/mL, TRAbs < 1.8 IU/mL. Normal foetal values for TSH, fT4, fT3, according to gestational age, were described by Hume and Guibourdenche [36,37]. Neonatal TSH values for the Polish population, obtained in driedspot tests, were as follows: median TSH concentration 1.45 mIU/L, 23.5% TSH results ≤ 0.5 mIU/L, 95% TSH results ≤ 5 mIU/L, and 0.2% abnormal measurements > 12.0 mIU/L [38].…”

Section: Prace Oryginalnementioning

confidence: 96%

Nadczynność tarczycy w ciąży — rola oznaczania przeciwciał przeciwko receptorowi TSH i ultrasonograficznego monitorowania płodu

Gietka-Czernel¹,

Dębska²,

Kretowicz³

et al. 2014

Endokrynologia Polska

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Introduction: To evaluate the usefulness of measuring maternal anti-TSH receptor antibodies (TRAbs) and foetal ultrasound (US) monitoring in cases of current or past maternal hyperthyroidism. Material and methods: 77 pregnant women suffering from hyperthyroidism or with a history of Graves' hyperthyroidism were observed prospectively. Maternal serum TSH, fT4, fT3, TRAbs, and foetal US were performed at baseline and repeated every 2-4 weeks when needed. Neonatal thyroid status was assessed based on serum TSH, fT4 and fT3 obtained in the first days of life. Results: 35 women were diagnosed with gestational hyperthyroidism and 42 with Graves' disease; among them 26 had current and 16 past hyperthyroidism. Foetal and neonatal thyroid dysfunction occurred only in cases of maternal Graves' disease: nine (21%) and three (7%), respectively. Active maternal Graves' hyperthyroidism and TRAbs elevated at least five times above the upper normal limit predisposed to foetal hyperthyroidism. Maternal anti-thyroid drug therapy (ATD) and low TRAbs and fT4 were the risk factors of foetal hypothyroidism. Abnormal foetal thyroid sonogram was the only sign of foetal thyroid dysfunction. Four patients (9.5%) had high TRAbs in the 3 rd trimester (10.8-29.9 IU/mL), but neither foetal nor neonatal thyroid dysfunctions were noted. Conclusions: In the cases of maternal Graves' disease, foetal thyroid dysfunction occurs more often than commonly assumed. Foetal thyroid US is a valuable tool in early diagnosis and monitoring of the foetal thyroid status in pregnancy complicated by maternal Graves' disease. The evaluation of biological activity of maternal TRAbs may be helpful in prenatal diagnosis in some cases.

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“…3). Foetal umbilical blood sampling was performed and hormonal results were mildly thyrotoxic: TSH -0.79 mIU/mL (normal mean ± SD 6.4 ± 4.85 mIU/mL), fT4 -25.9 pmol/L (normal mean ± SD 17.6 ± 3.0 pmol/L), fT3 -2.45 pg/mL (normal 0.3-1.9), TRAb -31.6 IU/mL [6,7]. MMI 10 mg daily was instituted to the mother and one week later at 36 WG preterm delivery occurred.…”

Section: Case Reportmentioning

confidence: 99%

Zwiększone rozmiary i unaczynienie, zmniejszona echogeniczność tarczycy płodu w ultrasonografii dwuwymiarowej spowodowane chorobą Gravesa i Basedowa u matki

Gietka-Czernel¹,

Dębska²,

Kretowicz³

et al. 2014

Endokrynologia Polska

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Foetal ultrasonography monitoring is a valuable tool in assessing foetal thyroid function when pregnancy is complicated by maternal Graves' disease with accompanying high levels of TSH receptor antibodies, or when antithyroid drug therapy is instituted. Among several ultrasonographic signs of foetal thyroid disorder such as abnormalities in bone maturation and heart rhythm, cardiac failure, hydrops, intrauterine growth restriction and polyhydramnios, goitre is the most sensitive one. Here we report three cases of pregnant women with Graves' disease accompanied by very high serum levels of TSH receptor antibodies. In all three cases, as documented by foetal or neonatal serum TSH and thyroid hormones measurements, foetal thyroid dysfunction occurred. The only ultrasonographic sign of foetal involvement was a goitre with decreased echogenicity and increased vascularisation, central or peripheral. This is the first report demonstrating that a foetal thyroid gland when affected by transplacental passage of maternal TSH receptor stimulating antibodies can present exactly the same characteristic ultrasound pattern of Graves' disease as in adults. StreszczenieU ciężarnej z chorobą Gravesa i Basedowa współczesne rekomendacje zalecają ultrasonograficzne monitorowanie płodu w przypadkach podwyższonego stężenia przeciwciał przeciwko receptorowi TSH lub leczenia tyreostatycznego. Spośród wielu objawów dysfunkcji tarczycy u płodu, które mogą być stwierdzone w ultrasonografii, takich jak: zaburzenia rytmu i niewydolność serca, obrzęk płodu, zaburzenia dojrzewania układu kostnego, zahamowanie wzrostu wewnątrzmacicznego i wielowodzie, najczulszym wskaźnikiem jest obecność wola. Prezentujemy 3 przypadki ciąży powikłanej matczyną chorobą Gravesa i Basedowa z towarzyszącymi bardzo wysokimi stężeniami przeciwciał przeciwko receptorowi TSH. We wszystkich 3 przypadkach wystąpiła płodowa dysfunkcja tarczycy, co potwierdzono badaniami hormonalnymi przeprowadzonymi u płodu lub noworodka. W każdym przypadku jedynym ultrasonograficznym objawem płodowej dysfunkcji tarczycy był charakterystyczny obraz gruczołu tarczowego, który wykazywał zwiększone rozmiary i unaczynienie oraz zmniejszoną echogeniczność. Jest to pierwsze doniesienie dokumentujące, że tarczyca płodu pod wpływem działania matczynych przeciwciał stymulujących receptor TSH wykazuje w badaniu ultrasonograficznym takie same charakterystyczne zmiany jak tarczyca dorosłego z chorobą Gravesa i Basedowa.

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Biochemical investigation of foetal and neonatal thyroid function using the ACS-180SE analyser: clinical application

Cited by 13 publications

References 4 publications

Thyroid Function in Fetuses with Down Syndrome

Thyroid Function in Fetuses with Down Syndrome

Nadczynność tarczycy w ciąży — rola oznaczania przeciwciał przeciwko receptorowi TSH i ultrasonograficznego monitorowania płodu

Zwiększone rozmiary i unaczynienie, zmniejszona echogeniczność tarczycy płodu w ultrasonografii dwuwymiarowej spowodowane chorobą Gravesa i Basedowa u matki

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