Muñoz Pérez Tomás, Peña Manubens María Fernanda, Román Reyes Rossana, Riquelme Romero Joel
Universidad de Chile, Santiago, Chile.
Hospital San Juan de Dios, Santiago, Chile.
Andes Pediatr. 2021 Aug;92(4):556-564. doi: 10.32641/andespediatr.v92i4.3454.
Neonatal hyperthyroidism is a disease that can cause mortality and sequelae. To date, there is no clinical series of cases that allows us to know the local reality of this condition.
to charac terize the children of mothers with Graves' disease (GD) from a clinical and biochemical point of view.
A prospective follow-up of all newborns (NB) of mothers with history of GD was performed in two public hospitals in Santiago, during 5 years. Clinical and laboratory variables of mother-child pairs and thyroid-stimulating hormone receptor antibodies (TRAbs) le vels were analyzed looking for associations between these variables and the development of neonatal hyperthyroidism.
Seventy-six mother-child pairs were included (0.2% of all deliveries). Five neonates (6.6%) presented biochemical hyperthyroidism, and 3 of them developed clinical disease and required treatment. All 5 NBs who developed hyperthyroidism had mothers with positive or indeterminate TRAbs. No child of TRAbs-negative mothers developed the disease. TRAbs could be determined in only 65% of the mothers and 72% of the NBs. There was a significant correlation bet ween maternal TRAbs titers (p < 0.03), neonatal TRAbs titers (p < 0.008), and neonatal TSH between days 2-6 (p < 0.006), with the subsequent development of hyperthyroidism. All cases of neonatal hyperthyroidism were transient. There was no mortality in our series.
This is the first national case series of children of mothers with GD. Maternal and neonatal TRAbs and TSH between days 2-6 of life were predictors of neonatal hyperthyroidism.
新生儿甲状腺功能亢进症是一种可导致死亡和后遗症的疾病。迄今为止，尚无临床病例系列能让我们了解该病症在当地的实际情况。
从临床和生化角度对患有格雷夫斯病（GD）母亲的子女进行特征描述。
在圣地亚哥的两家公立医院对所有有GD病史母亲的新生儿进行了为期5年的前瞻性随访。分析母婴对的临床和实验室变量以及促甲状腺激素受体抗体（TRAbs）水平，以寻找这些变量与新生儿甲状腺功能亢进症发生之间的关联。
纳入了76对母婴（占所有分娩的0.2%）。5名新生儿（6.6%）出现生化性甲状腺功能亢进，其中3名发展为临床疾病并需要治疗。所有发生甲状腺功能亢进的5名新生儿的母亲TRAbs均为阳性或不确定。TRAbs阴性母亲的孩子均未患该病。仅65%的母亲和72%的新生儿可检测到TRAbs。母亲TRAbs滴度（p < 0.03）、新生儿TRAbs滴度（p < 0.008）与出生后第2 - 6天的新生儿促甲状腺激素（p < 0.006）之间存在显著相关性，且随后会发展为甲状腺功能亢进症。所有新生儿甲状腺功能亢进症病例均为短暂性。本系列中无死亡病例。
这是首个关于患有GD母亲子女的全国性病例系列。出生后第2 - 6天的母亲和新生儿TRAbs及促甲状腺激素是新生儿甲状腺功能亢进症的预测指标。
