Nygaard B, Petersen J R, Jespersen N F
Medicinsk endokrinologisk afdeling F. Amtssygehuset i Herlev.
Ugeskr Laeger. 1997 Feb 17;159(8):1086-9.
Thyroid stimulating antibodies (TSAb) are thought to be involved in the initiation of Graves' disease, and thyrotoxicosis in the neonatal period is often caused by TSAb passing the placental barrier. We wanted to evaluate measurement of TSAb levels as a possible predictor of neonatal thyrotoxicosis in pregnant patients with Graves' disease. We retrospectively evaluated 18 consecutive pregnant patients with Graves' disease. In 16 patients TSAb were measured in early pregnancy, six had increased values. In 14 of 18 patients normal values were found in late pregnancy and none of the children developed neonatal thyrotoxicosis. Two patients had greatly elevated TSAb values, and their children had neonatal thyrotoxicosis. Two patients had slightly elevated TSAb levels and delivered normal children. We conclude that all pregnant patients with an actual or a history of Graves' disease, should have measured TSAb. High TSAb values in late pregnancy indicate a considerable risk of neonatal thyrotoxicosis.
促甲状腺素受体抗体(TSAb)被认为与格雷夫斯病的发病有关,新生儿期的甲状腺毒症通常是由TSAb通过胎盘屏障引起的。我们想评估TSAb水平的测定作为格雷夫斯病孕妇新生儿甲状腺毒症可能预测指标的价值。我们回顾性评估了18例连续的格雷夫斯病孕妇。16例患者在孕早期检测了TSAb,其中6例值升高。18例患者中有14例在孕晚期检测值正常,其子女均未发生新生儿甲状腺毒症。2例患者的TSAb值大幅升高,其子女发生了新生儿甲状腺毒症。2例患者的TSAb水平略有升高,分娩的子女正常。我们得出结论,所有有格雷夫斯病实际病史的孕妇都应检测TSAb。孕晚期TSAb值高表明新生儿甲状腺毒症风险相当高。