Fetal thyrotoxicosis is a rare condition with high morbidity and mortality. It may complicate pregnancies in women with a history of Graves disease (GD) when transplacental passage of maternal TSH receptor antibodies stimulate the fetal thyroid gland and cause hyperthyroidism. We report the case of a 34-year-old woman with a history of GD and prior thyroidectomy, where fetal thyrotoxicosis at 21 weeks of gestation was suspected due to prenatal ultrasound findings of cardiac failure and fetal goiter. She was treated with high-dose carbimazole and followed closely by a multidisciplinary team. Her baby was delivered in good condition at 34 weeks' gestation and developed hyperthyroidism in the days after birth, which was successfully treated medically. This case highlights the importance of awareness of the condition among women with a history of GD, as well as the necessity for prompt diagnosis and treatment of this complex disease.
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http://dx.doi.org/10.1210/jcemcr/luae060 | DOI Listing |
Horm Metab Res
December 2024
Department of Endocrinology and Metabolism, Lanzhou University Second Clinical Medical School, Lanzhou, China.
Thyrotropin receptor antibodies (TRAb) are specific for Graves' disease (GD) and play a crucial role in the pathogenesis of GD. TRAb assays have recently been greatly improved. This review discusses the clinical application of TRAb in the differential diagnosis of hyperthyroidism, the prognosis of GD, GD in gestation and pediatrics, and GD related ophthalmopathy (GO).
View Article and Find Full Text PDFCureus
September 2024
Department of Endocrinology, Diabetes, and Metabolism, Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto, PRT.
With a multifactorial etiology, syncope is a fairly common clinical presentation in emergency care. During pregnancy, it can result from hemodynamic and hormonal changes. One such rare cause is hyperthyroidism.
View Article and Find Full Text PDFEndocr Pract
January 2025
Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts. Electronic address:
Objective: Thyrotoxicosis can adversely affect pregnancy. The quality of care (QoC) for thyrotoxicosis in pregnancy at a tertiary care safety net hospital was evaluated based on current guidelines.
Methods: Pregnant patients with thyrotoxicosis or a history of Graves disease who delivered in 2015-2021 were divided into 3 groups: low thyroid stimulating hormone (TSH), active Graves disease, and past Graves disease.
Children (Basel)
August 2024
Division of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Fetal and neonatal thyrotoxicosis occurs in up to 5% of pregnancies in mothers with Graves' disease (GD). This condition is caused by stimulating antibodies against the thyrotropin receptor (TRAbs) that cross the placenta and may stimulate the fetal thyroid, typically in the second half of pregnancy. GD is often treated with radioiodine, resulting in hypothyroidism in most patients, but TRAbs can persist for several years.
View Article and Find Full Text PDFPituitary
December 2024
Mount Sinai Center of Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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