Different Forms of Hypothyroidism in Infants with Maternal Graves' Disease: A Case Series

Alexis Anand Dass Lordudass; Jeanne Sze-Lyn Wong; Nalini Selveindran; Janet Yeow Hua Hong

doi:10.15605/jafes.039.01.06

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
Nalini Selveindran Putrajaya Hospital
Janet Yeow Hua Hong Putrajaya Hospital

DOI:

https://doi.org/10.15605/jafes.039.01.06

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

Consultant Paediatric Endocrinologist

Nalini Selveindran, Putrajaya Hospital

Consultant Paediatric Endocrinologist, Paediatric Endocrine Unit, Paediatric Department

Janet Yeow Hua Hong, Putrajaya Hospital

Consultant Paediatric Endocrinologist, Paediatric Endocrine Unit, Paediatric Department

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