Fetal goitrous hypothyroidism followed by neonatal transient hyperthyroidism. A case report.
We report a case of fetal goitrous hypothyroidism followed by neonatal transient hyperthyroidism. A fetal goiter (26 x 38 mm) was detected by ultrasound and magnetic resonance imaging at 29 weeks of gestation. Hypothyroidism was confirmed by cordocentesis, which revealed an elevated TSH (255 microIU/ml) and a low free T4 (0.4 ng/dl). The fetal goiter decreased in size after treatment with four 240-microgram intra-amniotic administrations of levothyroxine. A 2,829-gram male neonate was delivered vaginally at 37 weeks of gestation, showing an euthyroid status at birth. On day 3, free T3 was 6.9 pg/ml and free T4 was 6.4 ng/dl, indicating hyperthyroidism. This persisted for 4 months. His thyroid functions reverted to normal at 4 months of age and have been within normal range since. Undetermined factors might be involved in the development of thyroid dysfunction in the perinatal period.
Matsumoto
Tadashi
T
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Miyakoshi
Kei
K
Kasai
Kenji
K
Ishimoto
Hitoshi
H
Tanaka
Mamoru
M
Ikeda
Kazushige
K
Yoshimura
Yasunori
Y
D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006042:Goiter / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D013974:Thyroxine / Q000627:therapeutic use
D013974:Thyroxine