Azzopardi Peter, Forrester Mike, Ehtisham Sarah
Paediatric Registrar, Royal Children's Hospital, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2010 Jul;46(7-8):439-41. doi: 10.1111/j.1440-1754.2009.01687.x. Epub 2010 Feb 16.
Thyrotropin receptor blocking antibodies are a rare cause of hyperthyrotropinaemia and more rarely of congenital hypothyroidism. We report a case of hyperthyrotropinaemia but normal thyroid hormone in the newborn of a mother with hypothyroidism treated with thyroxine. Two older siblings had similar high thyrotropin and normal thyroid function in the newborn period which did not require hormone treatment and resolved spontaneously. Demonstration of thyrotropin receptor antibodies in the child confirmed our diagnosis. Our case was not treated with thyroid replacement hormone and has remained biochemically euthyroid, with thyrotropin levels returning to normal over a period of months.
促甲状腺激素受体阻断抗体是导致促甲状腺激素血症的罕见原因,更是先天性甲状腺功能减退症的罕见病因。我们报告了一例促甲状腺激素血症病例,该病例中新生儿甲状腺激素水平正常,其母亲患有甲状腺功能减退症并接受了甲状腺素治疗。该新生儿的两个哥哥姐姐在新生儿期也有类似的促甲状腺激素水平升高但甲状腺功能正常的情况,且无需激素治疗,症状自发缓解。在该患儿体内检测到促甲状腺激素受体抗体,这证实了我们的诊断。我们的这个病例未接受甲状腺替代激素治疗,生化指标一直维持在甲状腺功能正常状态,促甲状腺激素水平在数月内恢复正常。