Recurrent fetal thyrotoxicosis in woman with history of Hashimoto's thyroiditis

Rodó, Carlota; Deambrogio, Francesca; Serra, Laura; Pina, S.; Sánchez-Duran, Ma Ángeles

doi:10.1002/uog.17526

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…FT can be treated via the mother since antithyroid drugs (ATDs) cross the placenta. Although both PTU and methimazole treatment in the first trimester can cause birth defects (2–3% and 2–4%, respectively), PTU is preferred because its teratogenic effects tend to be less severe [6, 16]. In the second and third trimesters, methimazole is preferred over PTU because of PTU-associated risk of hepatotoxicity in the mother [8].…”

Section: Discussionmentioning

confidence: 99%

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Fetal Thyrotoxicosis due to Maternal TSH Receptor Stimulating Antibodies Causes Infant Central Hypothyroidism

et al. 2023

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Introduction: Women with a current diagnosis or past history of Graves’ disease (GD) are at risk of developing fetal thyrotoxicosis (FT) during pregnancy when they are inadequately treated, or because of placental passage of TSH receptor antibodies (TRAb). It is known that FT induced by high maternal thyroid hormone concentrations may result in infant (central) hypothyroidism. Case Presentation: In a euthyroid woman with a history of GD treated with radioactive iodide (I131), persistently high levels of maternal TRAb resulted in recurrent FT during two separate pregnancies, followed by neonatal hyperthyroidism and infant central hypothyroidism. Discussion: This case demonstrates the novel insight that FT due to high fetal thyroid hormone concentrations stimulated by high maternal TRAb levels might also result in (central) hypothyroidism, requiring long-term evaluation of the hypothalamus-pituitary-thyroid axis in these children.

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Section: Discussionmentioning

confidence: 99%

“…FT is an infrequent condition which develops in 1–5% of pregnancies in women with past or current (treated) GD [1]. Recurrent FT is very rare [5‒7]. FT is associated with fetal morbidity and a reported intrauterine fetal death rate of up to 20% of cases [1].…”

Section: Discussionmentioning

confidence: 99%

Fetal Thyrotoxicosis due to Maternal TSH Receptor Stimulating Antibodies Causes Infant Central Hypothyroidism

et al. 2023

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“…Selenium deficiency inhibits the expression of CD8+ T cells, enhances the function of helper T cells, causes B lymphocytes to synthesize a large number of antithyroid antibodies, promotes the activation of thyroid peroxidase, and ultimately damages thyroid tissue. Selenium supplementation can effectively improve these pathological and physiological changes[ 17 , 18 ]. In addition, selenium supplementation can effectively enhance the antioxidant capacity of the thyroid gland, reduce thyroid cell damage, inhibit the expression of thyroglobulin and thyroid peroxidase, and improve the immune status of children.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children

Zhang¹,

Yuan²,

Chen³

2022

WJCC

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BACKGROUND The incidence of toxic diffuse goiter (Graves’ disease) is higher in adolescents and preschool-aged children, with an upward trend. The incidence at 6–13 years of age is approximately 11.0%, and the incidences in men and women are 7.8% and 14.3%, respectively. AIM To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter (Graves’ disease) in children and its effect on serum anti-thyroglobulin antibody (TRAb) and anti-thyroid peroxidase antibody (TPOAb). METHODS A total of 103 children with Graves’ disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group (15-20 mg methimazole orally given to children) and a combined group (50 µg selenium added on the basis of traditional treatment) according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb, TPOAb, free thyroxine (FT4) and inflammatory factor levels before and after treatment. The time taken for FT4 to return to normal was compared between the two groups. RESULTS Treatment was significantly more effective in the combined group than in the traditional group ( P < 0.05). The thyroid volumes of the children in the two groups was measured before and after treatment. Thyroid volume decreased significantly after treatment in both groups, and the thyroid volume was significantly lower in the combined group than in the traditional group ( P < 0.05). The serum levels of interleukin-6 (IL-6), IL-8, TRAb, TPOAb and FT4 in the two groups were detected before and after treatment. The levels of IL-6, IL-8, TRAb, TPOAb and FT4 were significantly lower in the combined group than in the traditional group ( P < 0.05). Follow-up of the children in the two groups showed that compared with the traditional group, it took less time for children in the combined group to return to the normal level ( P < 0.05). CONCLUSION Methimazole combined with selenium can effectively treat Graves’ disease in children, reduce the expression of TRAb, TPOAb, FT4 and inflammatory factors, and improve the curative effect. Thus, the combined treatment warrants further clinical research.

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Management of foetal hyperthyroidism in a mother with autoimmune hypothyroidism: A case report

Fernández

Rovira

Pérez

et al. 2023

Endocrinología, Diabetes y Nutrición (English ed.)

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Recurrent fetal thyrotoxicosis in woman with history of Hashimoto's thyroiditis

Cited by 4 publications

References 2 publications

Fetal Thyrotoxicosis due to Maternal TSH Receptor Stimulating Antibodies Causes Infant Central Hypothyroidism

Fetal Thyrotoxicosis due to Maternal TSH Receptor Stimulating Antibodies Causes Infant Central Hypothyroidism

Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children

Management of foetal hyperthyroidism in a mother with autoimmune hypothyroidism: A case report

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