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 Vol. 9 No. 7, July 2008
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NeoReviews Vol.9 No.7 2008 e305
© 2008 American Academy of Pediatrics

Neonatal Graves Disease Caused by Transplacental Antibodies

Maria Isabel Hernandez, MD*
Kuk-Wha Lee, MD, PhD*

* Division of Endocrinology, Department of Pediatrics, Mattel Children's Hospital at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, Calif

Autoimmune thyroid disease is common in pregnancy. Graves disease is present in about 0.2% of pregnancies, and clinical hyperthyroidism occurs in approximately 1% of neonates born to women who have Graves disease. Antibodies to the thyroid-stimulating hormone receptor (TSH-R) (stimulating or blocking) freely cross the placenta and can act in the fetal thyroid gland during the second half of pregnancy. A few cases of fetal hyperthyroidism or hypothyroidism related to maternal TSH-R antibodies (TRAbs) have been reported. Neonatal hyperthyroidism or thyrotoxicosis is usually apparent by 10 days after birth. Such states should be considered emergencies and treated promptly to prevent damage in the newborn.

Abbreviations: ATD: antithyroid drug • FT3: free triiodothyronine • FT4: free thyroxine • T4: thyroxine • TRAb: thyroid-stimulating hormone receptor antibody • TRH: thyrotropin-releasing hormone • TSAb: thyroid-stimulating hormone-stimulating antibody • TSBAb: thyroid stimulating hormone-blocking antibody • TSH: thyroid-stimulating hormone • TSH-R: thyroid-stimulating hormone receptor






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Copyright © 2008 by the American Academy of Pediatrics.