Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism

Endocrine Journal

Koichi Ito⁴  Jaeduk Yoshimura Noh⁴  Naoko Momotani³  Noboru Hamada¹  Kunihiko Ito⁴  Naofumi Ishikawa⁴  Yasuyuki Okamoto²  Toshiaki Konishi¹ 

[1] Sumire Hospital, Osaka, Japan;Sumire Clinic, Osaka, Japan;Tokyo Health Service Association, Tokyo, Japan;Ito Hospital, Tokyo, Japan

关键词: TSH receptor antibody;    Graves’ disease;    Neonatal hyperthyroidism;    Radioiodine treatment;    Pregnancy;   

DOI  :  10.1507/endocrj.K10E-123

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(14)Cited-By(12)Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves’ disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism.The aim of this retrospective study is to investigate the characteristics of Graves’ women who had a history of radioiodine treatment for intractable Graves’ disease, and whose neonates suffered from hyperthyroidism.The subjects of this study were 45 patients with Graves’ disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital.25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves’ disease.19 pregnancies were excluded because of artificial or spontaneous abortion.In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients.Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother).Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy.In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves’ disease.Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

【 授权许可】

Unknown