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Open AccessReview
Neonatal Thyrotoxicosis in Infants of Mothers with Graves’ Disease Treated for Radioiodine-Induced Hypothyroidism: A Literature Review
by
Lucia Jankovski
Lucia Jankovski 1,
Štefan Grosek
Štefan Grosek 2,3,
Mojca Tanšek Žerjav
Mojca Tanšek Žerjav 4
,
Marijana Vidmar Šimic
Marijana Vidmar Šimic 5 and
Katja Zaletel
Katja Zaletel 6,7,*
1
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
2
Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
3
Department of Medical Ethics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
4
Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Division of Pediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
5
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
6
Division of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
7
Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Children 2024, 11(8), 968; https://doi.org/10.3390/children11080968 (registering DOI)
Submission received: 1 July 2024
/
Revised: 2 August 2024
/
Accepted: 9 August 2024
/
Published: 11 August 2024
Abstract
Fetal and neonatal thyrotoxicosis occurs in up to 5% of pregnancies in mothers with Graves’ disease (GD). This condition is caused by stimulating antibodies against the thyrotropin receptor (TRAbs) that cross the placenta and may stimulate the fetal thyroid, typically in the second half of pregnancy. GD is often treated with radioiodine, resulting in hypothyroidism in most patients, but TRAbs can persist for several years. Even if a pregnant mother is hypothyroid after radioiodine therapy or surgery, her TRAbs can still, although rarely, induce fetal hyperthyroidism. In this review, we first present two cases of neonatal hyperthyroidism in mothers with GD who became hypothyroid after prior radioiodine therapy, identified through a 10-year analysis of the National Perinatal System in Slovenia. Based on these cases, we provide an overview of existing data on this rare clinical condition in neonates. We also discuss the underlying mechanisms and clinical outcomes based on currently available data. In conclusion, our review highlights the importance of careful monitoring during pregnancy in all women with GD, even in those well managed after radioiodine therapy or surgery.
Share and Cite
MDPI and ACS Style
Jankovski, L.; Grosek, Š.; Žerjav, M.T.; Šimic, M.V.; Zaletel, K.
Neonatal Thyrotoxicosis in Infants of Mothers with Graves’ Disease Treated for Radioiodine-Induced Hypothyroidism: A Literature Review. Children 2024, 11, 968.
https://doi.org/10.3390/children11080968
AMA Style
Jankovski L, Grosek Š, Žerjav MT, Šimic MV, Zaletel K.
Neonatal Thyrotoxicosis in Infants of Mothers with Graves’ Disease Treated for Radioiodine-Induced Hypothyroidism: A Literature Review. Children. 2024; 11(8):968.
https://doi.org/10.3390/children11080968
Chicago/Turabian Style
Jankovski, Lucia, Štefan Grosek, Mojca Tanšek Žerjav, Marijana Vidmar Šimic, and Katja Zaletel.
2024. "Neonatal Thyrotoxicosis in Infants of Mothers with Graves’ Disease Treated for Radioiodine-Induced Hypothyroidism: A Literature Review" Children 11, no. 8: 968.
https://doi.org/10.3390/children11080968
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