Transient neonatal hypothyroidism due to transplacental transfer of maternal immunoglobulins that inhibit TSH binding, TSH-induced cAMP increase and cell growth.
Transient neonatal hypothyroidism due to transplacental transfer of maternal blocking type TSH receptor antibodies (TRAb) was found in a baby born to a 27-yr-old mother, who had been receiving thyroxine medication for primary myxedema. Maternal IgG inhibited radiolabelled TSH binding to its receptor (TBII), TSH-stimulated thyroid adenylate cyclase (AC) activation (TSII) and TSH-stimulated 3H-thymidine uptake (TGII) in cultured rat thyroid cells (FRTL-5). At birth, the baby's IgG showed similar activities to maternal IgG but all these activities decreased gradually, and disappeared from her serum within 12 weeks of age. In the baby, initially nonvisualized thyroid was clearly visualized on 99 m-Tc thyroid scintigraphy when all these blocking activities disappeared, TSII and TGII being decreased more slowly than TBII, and the baby remained euthyroid after discontinuation of thyroxine. This study suggests that such IgGs induced hypothyroidism and thyroid atrophy in the mother and were responsible for transient neonatal hypothyroidism in the baby.
Cho
B Y
BY
Department of Internal Medicine, College of Medicine, Seoul National University, Korea.
Shong
Y K
YK
Lee
H K
HK
Koh
C S
CS
Min
H K
HK
Lee
M
M
D000328:Adult; D002455:Cell Division; D003409:Congenital Hypothyroidism; D000242:Cyclic AMP / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000276:immunology*; D007112:Immunity, Maternally-Acquired; D007074:Immunoglobulin G / Q000378:metabolism*; D018828:Immunoglobulins, Thyroid-Stimulating; D007231:Infant, Newborn; D011247:Pregnancy; D011989:Receptors, Thyrotropin / Q000276:immunology / Q000378:metabolism; D013972:Thyrotropin / Q000276:immunology / Q000378:metabolism
D007074:Immunoglobulin G; D018828:Immunoglobulins, Thyroid-Stimulating; D011989:Receptors, Thyrotropin; D013972:Thyrotropin; D000242:Cyclic AMP