母亲促甲状腺素受体抗体引起的新生儿短暂性甲状腺功能减退继发甲状腺功能亢进。

JCEM case reports Pub Date : 2025-03-07 eCollection Date: 2025-03-01 DOI:10.1210/jcemcr/luaf040
Mark Garrelfs, Gerdine A Kamp, A S Paul van Trotsenburg
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引用次数: 0

摘要

母亲甲状腺功能障碍会对胎儿和/或新生儿甲状腺激素稳态产生负面影响。与自身免疫性甲状腺疾病相关的自身抗体可以穿过胎盘。TSH受体抗体(TRAbs)可以刺激或阻断TSH受体,两种类型的抗体都可以出现在同一个人身上。trb是格雷夫斯病中最重要的抗体,但也在一定比例的桥本病女性中发现。主要TRAb类型的性质(刺激型或阻断型)通常会决定临床表现。我们描述了一个罕见的新生儿甲状腺功能减退症,随后由母体trab引起的甲状腺功能亢进,与桥本病有关。与类似病例相比,母亲未使用抗甲状腺药物治疗,这为出生后阻断和刺激trab之间的平衡逐渐改变以及它们对新生儿甲状腺功能的不同影响提供了证据。本病例强调需要定期甲状腺功能测试的新生儿高滴度,直到母体抗体被清除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transient Neonatal Hypothyroidism Followed by Hyperthyroidism Due to Maternal Thyrotropin Receptor Antibodies.

Maternal thyroid dysfunction can negatively influence fetal and/or neonatal thyroid hormone homeostasis. Autoantibodies associated with autoimmune thyroid disease can cross the placenta. TSH receptor antibodies (TRAbs) can either stimulate or block the TSH receptor, and both types of antibodies can be present in the same person. TRAbs are the most important antibodies in Graves' disease but are also found in a percentage of women with Hashimoto disease. Properties of the dominant TRAb type (stimulating or blocking) will generally dictate the clinical picture. We describe a rare case of neonatal hypothyroidism followed by hyperthyroidism caused by maternal TRAbs, associated with Hashimoto disease. In contrast to similar cases, the mother was not treated with antithyroid drugs, providing evidence for the gradually changing balance between blocking and stimulating TRAbs after birth and their different effects on neonatal thyroid function. This case highlights the need for regular thyroid function tests in neonates with high TRAb titers until maternal antibodies are cleared.

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