Rakuś-Kwiatosz Anna, Dorosz-Hreńczuk Beata, Beń-Skowronek Iwona
Pediatr Endocrinol Diabetes Metab. 2013;19(2):82-4.
Congenital goiter is a rare condition which can be associated with both fetal hyper- and hypothyroidism. It may result from different situations in maternal-fetal thyroid function because antithyroid medication, iodine as well as stimulatory and inhibitory antibodies readily cross the placenta. Aim of the study is the presentation of a newborn infant with congenital goiter and neonatal thyroid suppression that could be attributed to either an in utero exposure to antithyroid drug - propylthiouracil (PTU) or mother´s blocking antibodies.
Full term neonate was born with enlarged thyroid and signs (laboratory findings) of congenital hypothyroidism. The mother was treated due to hyperthyroidism between 8 and 12 week of pregnancy and presented thyroid-stimulating immunoglobulins (TSI) after delivery. During the treatment with replacement doses of L-thyroxin in infancy period no thyroid antibodies in the child were detected.
The most probable reason was the negative influence of PTU: very high thyroid stimulating hormone (TSH) level since delivery and goiter development indicate that fetal hypothyroidism had been developing for a long time.
先天性甲状腺肿是一种罕见病症,可与胎儿甲状腺功能亢进和减退相关。由于抗甲状腺药物、碘以及刺激性和抑制性抗体容易穿过胎盘,它可能由母胎甲状腺功能的不同情况引起。本研究的目的是介绍一名患有先天性甲状腺肿和新生儿甲状腺功能抑制的新生儿,其病因可能是子宫内接触抗甲状腺药物丙硫氧嘧啶(PTU)或母亲的阻断抗体。
足月新生儿出生时甲状腺肿大,并伴有先天性甲状腺功能减退的体征(实验室检查结果)。母亲在怀孕8至12周期间因甲状腺功能亢进接受治疗,产后出现促甲状腺素受体抗体(TSI)。在婴儿期用替代剂量的左甲状腺素治疗期间,未检测到患儿的甲状腺抗体。
最可能的原因是PTU的负面影响:自出生以来甲状腺刺激激素(TSH)水平极高以及甲状腺肿的发展表明胎儿甲状腺功能减退已持续很长时间。