Manifestations of Hypothyroidism in Infants with Maternal Graves' Disease

A Case Series

Authors

  • Alexis Anand Dass Lordudass Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia https://orcid.org/0000-0002-1228-4835
  • Jeanne Sze-Lyn Wong Sunway Specialist Centre Damansara, Kota Damansara, Petaling Jaya, Selangor, Malaysia
  • Nalini M Selveindran Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia
  • Janet Yeow Hua Hong Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia

Keywords:

Infants, Central hypothyroidism, Primary Hypothyroidism, Congenital hypothyroidism, Maternal Grave’s disease, Maternal hyperthyroidism

Abstract

Infants of mothers with Graves’ disease (GD) may develop central hypothyroidism (CH) due to exposure of the foetal hypothalamic-pituitary-thyroid axis to higher-than-normal thyroid hormone concentrations, primary hypothyroidism (PH) due to transplacental passage of maternal thyroid stimulating hormone receptor antibody (TRAb), antithyroid drugs (ATD) or thyroid dysgenesis secondary to maternal uncontrolled hyperthyroidism. We describe two infants with PH and four infants with CH born to mothers with poorly controlled Graves' disease. All infants required levothyroxine and had normal developmental milestones. While national guideline consensus for high thyroid stimulating hormone (TSH) on neonatal screening is well-established, thyroid function tests (TFTs) should be serially monitored in infants with low TSH on screening, as not all mothers with Graves’ disease are diagnosed antenatally.

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Author Biographies

Alexis Anand Dass Lordudass, Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia

Fellow, Paediatric Endocrine Unit, Paediatric Department,

 

Jeanne Sze-Lyn Wong, Sunway Specialist Centre Damansara, Kota Damansara, Petaling Jaya, Selangor, Malaysia

Consultant Paediatric Endocrinologist

Nalini M Selveindran, Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia

Consultant Paediatric Endocrinologist, Paediatric Endocrine Unit, Paediatric Department

Janet Yeow Hua Hong, Putrajaya Hospital, Wilayah Persekutuan Putrajaya, Malaysia

Consultant Paediatric Endocrinologist, Paediatric Endocrine Unit, Paediatric Department

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Kempers MJ, van Tijn DA, van Trotsenburg AS, de Vijlder JJ, Wiedijk BM, Vulsma T. Central congenital hypothyroidism due to gestational hyperthyroidism: Detection where prevention failed. J Clin Endocrinol Metab. 2003;88(12):5851-7.

https://pubmed.ncbi.nlm.nih.gov/14671180. https://doi.org/10.1210/jc.2003-030665.

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Published

2024-01-05

How to Cite

Lordudass, A. A. D., Wong, J. S.-L., Selveindran, N., & Hong, J. Y. H. (2024). Manifestations of Hypothyroidism in Infants with Maternal Graves’ Disease: A Case Series. Journal of the ASEAN Federation of Endocrine Societies. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/2721

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Early Access Articles

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Case Series

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Copyright (c) 2024 Alexis Anand Dass Lordudass, Jeanne Sze-Lyn Wong, Nalini M Selveindran, Janet Yeow Hua Hong

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