Kung A W, Low L C
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
J Paediatr Child Health. 1992 Feb;28(1):50-3. doi: 10.1111/j.1440-1754.1992.tb02617.x.
The role of transplacental transfer of maternal thyrotrophin (TSH)-blocking antibodies causing congenital hypothyroidism in Southern Chinese children was examined in this study. Twenty-two mothers of 24 patients with congenital hypothyroidism were studied 3-5 years after delivery. None of them had thyroid dysfunction at delivery or at the time of study. None had antithyroglobulin or antimicrosomal antibody. Only one mother was found to have TSH-binding inhibitory immunoglobulin (TBII), and her child had agenesis of the thyroid. This women had Graves disease in remission for 2 years before delivery. None had TSH-stimulated cAMP response inhibitory immunoglobulin (TSII). Ten of the 24 congenital hypothyroid children had transient neonatal hypothyroidism, seven had agenesis of the thyroid, six had dyshormonogenesis and one had a sublingual thyroid. As none of the mothers who had children with transient neonatal hypothyroidism had blocking antibodies at the time of study, the aetiology of the transient neonatal hypothyroidism remains unclear. These data suggest that maternal TSH-blocking antibodies do not play a role in most cases of sporadic congenital hypothyroidism.
本研究探讨了母体促甲状腺素（TSH）阻断抗体经胎盘转移在中国南方儿童先天性甲状腺功能减退症发病中的作用。对24例先天性甲状腺功能减退症患儿的22位母亲在分娩后3至5年进行了研究。她们在分娩时及研究时均无甲状腺功能障碍。均无抗甲状腺球蛋白或抗微粒体抗体。仅发现1位母亲有TSH结合抑制性免疫球蛋白（TBII），其孩子甲状腺缺如。该女性在分娩前2年患格雷夫斯病，病情缓解。均无TSH刺激的环磷酸腺苷（cAMP）反应抑制性免疫球蛋白（TSII）。24例先天性甲状腺功能减退症患儿中，10例有短暂性新生儿甲状腺功能减退症，7例甲状腺缺如，6例有激素合成障碍，1例有舌下甲状腺。由于患有短暂性新生儿甲状腺功能减退症患儿的母亲在研究时均无阻断抗体，因此短暂性新生儿甲状腺功能减退症的病因仍不清楚。这些数据表明，母体TSH阻断抗体在大多数散发性先天性甲状腺功能减退症病例中不起作用。
