Yilmaz G Can, Anik A
Muğla Training and Research Hospital - Department of Pediatric Endocrinology, Muğla.
"Aydın Adnan" Menderes University, Faculty of Medicine - Department of Pediatric Endocrinology, Aydin, Turkey.
Acta Endocrinol (Buchar). 2023 Jul-Sep;19(3):386-389. doi: 10.4183/aeb.2023.386. Epub 2024 Feb 1.
Maternal antibodies in cases of chronic autoimmune thyroiditis may be transferred to the baby via the transplacental route, leading to transient hyperthyroidism or hypothyroidism. The development of hyperthyroidism in one sibling and hypothyroidism in the other, however, is an extremely rare condition. We present two siblings, one with transient neonatal hyperthyroidism and the other with transient neonatal hypothyroidism, born to a euthyroid mother who was being treated for Hashimoto's thyroiditis.
A term male baby was evaluated due to tachycardia, high fT4 and low TSH. Following a diagnosis of Neonatal thyrotoxicosis, the patient was started on methimazole and propranolol treatments. The doses were gradually reduced and methimazole was stopped in the 5 month of treatment. A male baby was referred with elevated TSH identified in the neonatal screening program, with TSH >100 mIU/L and fT4 7.5 pmol/l (N: 12-22) found in a venous blood sample. The patient was started on 50 µg/day LT4, which was gradually decreased and stopped when the baby was 5.5 months old.
It should be kept in mind that antibodies may change character in mothers with autoimmune thyroiditis, and may cause different clinical pictures in babies in different pregnancies.
慢性自身免疫性甲状腺炎患者体内的母体抗体可能通过胎盘途径传递给婴儿，导致短暂性甲状腺功能亢进或减退。然而，一个兄弟姐妹患甲状腺功能亢进而另一个患甲状腺功能减退的情况极为罕见。我们报告了一对兄弟姐妹，母亲患有桥本甲状腺炎，甲状腺功能正常，一个婴儿患有短暂性新生儿甲状腺功能亢进，另一个患有短暂性新生儿甲状腺功能减退。
一名足月儿男婴因心动过速、游离甲状腺素（fT4）升高和促甲状腺激素（TSH）降低接受评估。诊断为新生儿甲状腺毒症后，患者开始接受甲巯咪唑和普萘洛尔治疗。剂量逐渐减少，治疗5个月时停用甲巯咪唑。一名男婴在新生儿筛查项目中被发现TSH升高，静脉血样本中TSH>100 mIU/L，游离甲状腺素（fT4）为7.5 pmol/l（正常范围：12 - 22）。患者开始每天服用50μg左甲状腺素（LT4），剂量逐渐减少，婴儿5.5个月大时停药。
应牢记自身免疫性甲状腺炎母亲体内的抗体可能会改变性质，并可能在不同妊娠中导致婴儿出现不同的临床表现。
