Article ; Online: Fetal and Neonatal Thyroid Dysfunction.
The Journal of clinical endocrinology and metabolism
2021 Volume 107, Issue 3, Page(s) 836–846
Abstract: Fetal and neonatal dysfunctions include rare serious disorders involving abnormal thyroid function during the second half of gestation, which may persist throughout life, as for most congenital thyroid disorders, or be transient, resolving in the first ... ...
| Abstract | Fetal and neonatal dysfunctions include rare serious disorders involving abnormal thyroid function during the second half of gestation, which may persist throughout life, as for most congenital thyroid disorders, or be transient, resolving in the first few weeks of life, as in autoimmune hyperthyroidism or hypothyroidism and some cases of congenital hypothyroidism (CH) with the thyroid gland in situ. Primary CH is diagnosed by neonatal screening, which has been implemented for 40 years in developed countries and should be introduced worldwide, as early treatment prevents irreversible neurodevelopmental delay. Central CH is a rarer entity occurring mostly in association with multiple pituitary hormone deficiencies. Other rare disorders impair the action of thyroid hormones. Neonatal Graves' disease (GD) results from the passage of thyrotropin receptor antibodies (TRAbs) across the placenta, from mother to fetus. It may affect the fetuses and neonates of mothers with a history of current or past GD, but hyperthyroidism develops only in those with high levels of stimulatory TRAb activity. The presence of antibodies predominantly blocking thyroid-stimulating hormone receptors may result in transient hypothyroidism, possibly followed by neonatal hyperthyroidism, depending on the balance between the antibodies present. Antithyroid drugs taken by the mother cross the placenta, treating potential fetal hyperthyroidism, but they may also cause transient fetal and neonatal hypothyroidism. Early diagnosis and treatment are key to optimizing the child's prognosis. This review focuses on the diagnosis and management of these patients during the fetal and neonatal periods. It includes the description of a case of fetal and neonatal autoimmune hyperthyroidism. |
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| MeSH term(s) | Adult ; Autoantibodies/blood ; Autoantibodies/immunology ; Female ; Fetal Diseases/diagnosis ; Fetal Diseases/immunology ; Fetal Diseases/physiopathology ; Humans ; Infant, Newborn ; Neonatal Screening ; Thyroid Diseases/diagnosis ; Thyroid Diseases/immunology ; Thyroid Diseases/physiopathology ; Thyroid Gland/immunology ; Thyroid Gland/physiopathology ; Thyrotropin/immunology |
| Chemical Substances | Autoantibodies ; Thyrotropin (9002-71-5) |
| Language | English |
| Publishing date | 2021-10-12 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article ; Review |
| ZDB-ID | 3029-6 |
| ISSN | 1945-7197 ; 0021-972X |
| ISSN (online) | 1945-7197 |
| ISSN | 0021-972X |
| DOI | 10.1210/clinem/dgab747 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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