Fetal goitrous hypothyroidism due to maternal thyroid stimulation-blocking antibody: a case report.
Most fetal goitrous hypothyroidisms are reportedly caused by the maternal use of an antithyroid drug or fetal dyshormonogenesis. However, fetal goitrous hypothyroidism due to the transplacental passage of maternal thyroid stimulation-blocking antibody (TSBAb) is extremely rare. A woman at 28 weeks of gestation was found to have a fetal goiter by ultrasonography. Because the maternal serum showed hypothyroidism with an elevated titer of TSBAb, levothyroxine sodium was administered. The patient delivered a male infant, 3,412 g, with a goiter at term. Umbilical blood revealed primary hypothyroidism with increased TSBAb, and the infant was given levothyroxine sodium. After a month, neonatal thyroid function and TSBAb levels became normal. Attention should be paid to possible fetal hypothyroidism when a fetal goiter is observed to avoid impaired mental development of the neonate.
Ohira
Satoshi
S
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto, Japan.
Miyake
Masako
M
Kobara
Hisanori
H
Kikuchi
Norihiko
N
Osada
Ryosuke
R
Ashida
Takashi
T
Hirabayashi
Kanae
K
Nishio
Shin-ichi
S
Kanai
Makoto
M
Shiozawa
Tanri
T
D000328:Adult; D003409:Congenital Hypothyroidism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000276:immunology* / Q000503:physiopathology; D006042:Goiter / Q000151:congenital* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood*; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D014463:Ultrasonography
D018828:Immunoglobulins, Thyroid-Stimulating; C118905:thyroid stimulation-blocking antibody; D013974:Thyroxine