title: Successful use of iodine and levothyroxine to treat Graves' disease in a pregnant patient with allergy to antithyroid drugs and high thyrotropin-binding inhibitor immunoglobulin after radioiodine therapy.
abstract: High titer of thyrotropin-binding inhibitor immunoglobulin (TBII) in patients with Graves' disease can cause fetal hyperthyroidism during pregnancy. Prevention of fetal hyperthyroidism by administration of antithyroid drug (ATD) and levothyroxine (LT(4)) to pregnant patients who previously received ablative therapy has been reported. We administered iodine and LT(4) to a patient during gestation, because she had a severe adverse reaction to ATD. Although gestation proceeded normally, the infant showed transient neonatal hyperthyroidism right after birth. We believe that the fetus would have developed hyperthyroidism if we had not administered iodine to the mother. Administration of iodine and LT(4) to a pregnant patient with Graves' disease showing a high TBII after ablative therapy should be considered in rare patients with allergy to ATD.
authors.affiliation: Kuma Hospital, Kobe, Japan. kubota@kuma-h.or.jp
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Kubota
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ohye
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sasaki
authors.forename: Eijun
authors.initials: E
authors.lastname: Nishihara
authors.forename: Takumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Shuji
authors.initials: S
authors.lastname: Fukata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Amino
authors.forename: Kanji
authors.initials: K
authors.lastname: Kuma
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Mitsuda
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood*; D004342:Drug Hypersensitivity / Q000517:prevention & control; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating; D007455:Iodine / Q000008:administration & dosage*; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy*; D011989:Receptors, Thyrotropin / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage* / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating; D007457:Iodine Radioisotopes; D011989:Receptors, Thyrotropin; C094372:thyrotropin-binding inhibitory immunoglobulin; D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine