Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları

Kurtoğlu, Selim; ÖZDEMİR, Ahmet

Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları

Selim KURTOĞLU, (Erciyes Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Yenidoğan ve Çocuk Endokrinoloji Bilim Dalı, Kayseri, Türkiye)

Ahmet ÖZDEMİR (Erciyes Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Yenidoğan ve Çocuk Endokrinoloji Bilim Dalı, Kayseri, Türkiye)

Türk Pediatri Arşivi

5 2

Yıl: 2017 Cilt: 52 Sayı: 1 Sayfa Aralığı: 1 - 9 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları

Öz:

Graves hastalığı bulunan annelerde fetal ve neonatal hipertiroidi oluşabilir. Gebeliğin 17-20. haftasından itibaren TSH reseptör uyarıcı antikorların fetusa geçmesi ve fetal TSH cevabının 20. haftadan sonra olgunlaşmasıyla birlikte fetal tirotoksikoz tablosu gözlenir. Gebelikte fetal taşikardi, guatr, kemik yaşının ilerlemesi gibi bulgularla tanıya gidilir ve annenin tedavisi uygun şekilde sürdürülür. Gebeliğin son aylarında antitiroid gereksinimi devam eden ve antikor düzeyi yüksek olan anne bebeklerinde yenidoğan hipertiroidi olasılığı yüksektir. Annenin aldığı antitiroid ilaçlar nedeniyle klinik tablo 7-17 gün gecikebilir. Yenidoğan hipertiroidi bulguları sepsis, konjenital ve viral enfeksiyonlarla karışabilir. Yazıda fetal yenidoğan hipertiroidi olgularında tanı ve tedavi yaklaşımları gözden geçirilmiştir.

Anahtar Kelime:

Konular: Kadın Hastalıkları ve Doğum Genel ve Dahili Tıp

Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

Öz:

Fetal and neonatal hyperthyroidism may occur in mothers with Graves' disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7-17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism.

Anahtar Kelime:

Konular: Kadın Hastalıkları ve Doğum Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Lourenço R, Dias P, Gouveia R, Sousa AB, Oliveira G. Neonatal McCune-Albright syndrome with systemic involvement: a case report. J Med Case Rep 2015; 9: 189. [CrossRef]
2. Glinoer D. Management of hypo- and hyperthyroidism during pregnancy. Growth Horm IGF Res 2003; 13: S45- 54. [CrossRef ]
3. Smith CM, Gavranich J, Cotterill A, Rodda CP. Congenital neonatal thyrotoxicosis and previous maternal radioiodine therapy. BMJ 2000; 320: 1260-1. [CrossRef ]
4. Laurberg P, Wallin G, Tallstedt L, Abraham-Nordling M, Lundell G, Tørring O. TSH-receptor autoimmunity in Graves' disease after therapy with anti-thyroid, surgery, or radioiodine: a 5-year prospective randomized study. Eur J Endocrinol 2008; 158: 69-75. [CrossRef ]
5. Polak M, Legac I, Vuillard E, Guibourdenche J, Castanet M, Luton D. Congenital hyperthyroidism: the fetus as a patient. Horm Res 2006; 65: 235-42. [CrossRef ]
6. Luton D, Le Gac I, Vuillard E, et al. Management of Graves' disease during pregnancy: the key role of fetal thyroid gland monitoring. J Clin Endocrinol Metab 2005; 90: 6093-8. [CrossRef ]
7. Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21: 1081-125. [CrossRef ]
8. McLachlan SM, Rapoport B. Thyrotropin-blocking autoantibodies andthyroid-stimulating autoantibodies: potential mechanisms involved in the pendulum swinging from hypothyroidism to hyperthyroidism or vice versa. Thyroid 2013; 23: 14-24. [CrossRef ]
9. Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: manage- ment guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid 2011; 21: 593-646. [CrossRef ]
10. Rodríguez-García R. [Bilateral renal agenesis (Potter's syndrome) in a girlborn to a hyperthyroid mother who received methimazole in early pregnancy]. Ginecol Obstet Mex 1999; 67: 587-9.
11. Bánhidy F, Puhó EH, Czeizel AE. Possible association between hyperthyroidismin pregnant women and obstructive congenital abnormalities of urinary tract intheir offspring--a population-based case-control study. J Matern Fetal Neonatal Med 2011; 24: 305-12. [CrossRef ]
12. Ishikawa N. The relationship between neonatal developmental dysplasia of the hip and maternal hyperthyroidism. J Pediatr Orthop 2008; 28: 432- 4. [CrossRef ]
13. Andersen SL, Olsen J, Wu CS, Laurberg P. Severity of birth defects afterpropylthiouracil exposure in early pregnancy. Thyroid 2014; 24: 1533-40. [CrossRef ]
14. Simister NE. Placental transport of immunoglobulin G. Vaccine 2003; 21: 3365-9. [CrossRef ]
15. Segni M, Leonardi E, Mazzoncini B, Pucarelli I, Pasquino AM. Special features of Graves' disease in early childhood. Thyroid 1999; 9: 871-7. [CrossRef ]
16. Ranzini AC, Ananth CV, Smulian JC, Kung M, Limbachia A, Vintzileos AM. Ultrasonography of the fetal thyroid: nomograms based on biparietal diameter and gestational age. J Ultrasound Med 2001; 20: 613-7. [CrossRef ]
17. Huel C, Guibourdenche J, Vuillard E, Ouahba J, Piketty M, Oury JF, Luton D. Use of ultrasound to distinguish between fetal hyperthyroidism and hypothyroidism on discovery of a goiter. Ultrasound Obstet Gynecol 2009; 33: 412-20. [CrossRef ]
18. Goldstein I, Lockwood C, Belanger K, Hobbins J. Ultrasonographic assessment ofgestational age with the distal femoral and proximal tibial ossification centers in the third trimester. Am J Obstet Gynecol 1988; 158: 127-30. [CrossRef]
19. Smith C, Thomsett M, Choong C, Rodda C, McIntyre HD, Cotterill AM. Congenital thyrotoxicosis in premature infants. Clin Endocrinol (Oxf ) 2001; 54: 371-6. [CrossRef ]
20. Tamaki H, Amino N, Aozasa M, et al. Universal predictive criteria for neonatal overt thyrotoxicosis requiring treatment. Am J Perinatol 1988; 5: 152-8. [CrossRef ]
21. Mortimer RH, Tyack SA, Galligan JP, Perry-Keene DA, Tan YM. Graves' disease in pregnancy: TSH receptor binding inhibiting immunoglobulins and maternal and neonatal thyroid function. Clin Endocrinol (Oxf ) 1990; 32: 141-52. [CrossRef ]
22. Mitsuda N, Tamaki H, Amino N, Hosono T, Miyai K, Tanizawa O. Risk factors for developmental disorders in infants born to women with Graves disease. Obstet Gynecol 1992; 80: 359-64.
23. Levy-Shraga Y, Tamir-Hostovsky L, Boyko V, Lerner-Geva L, Pinhas-Hamiel O. Follow-up of newborns of mothers with Graves' disease. Thyroid 2014; 24: 1032-9. [CrossRef]
24. Zakarija M, McKenzie JM. Pregnancy-associated changes in the thyroid-stimulating antibody of Graves' disease and the relationship to neonatal hyperthyroidism. J Clin Endocrinol Metab 1983; 57: 1036-40. [CrossRef ]
25. Clark SM, Saade GR, Snodgrass WR, Hankins GD. Pharmacokinetics and pharmacotherapy of thionamides in pregnancy. Ther Drug Monit 2006; 28: 477-83. [CrossRef ]
26. Zakarija M, McKenzie JM, Munro DS. Immunoglobulin G inhibitor of thyroid-stimulating antibody is a cause of delay in the onset of neonatal Graves' disease. J Clin Invest 1983; 72: 1352-6. [CrossRef ]
27. Papendieck P, Chiesa A, Prieto L, Gruñeiro-Papendieck L. Thyroid disorders of neonates born to mothers with Graves' disease. J Pediatr Endocrinol Metab 2009; 22: 547-53. [CrossRef ]
28. O'Connor MJ, Paget-Brown AO, Clarke WL. Premature twins of a mother withGraves' disease with discordant thyroid function: a case report. J Perinatol 2007; 27: 388- 9. [CrossRef ]
29. Fisher DA. Fetal thyroid function: diagnosis and management of fetal thyroid disorders. Clin Obstet Gynecol 1997; 40: 16-31. [CrossRef ]
30. Besançon A, Beltrand J, Le Gac I, Luton D, Polak M. Management of neonatesborn to women with Graves' disease: a cohort study. Eur J Endocrinol 2014; 170: 855-62. [CrossRef ]
31. Markham LA, Stevens DL. A case report of neonatal thyrotoxicosis due to maternal autoimmune hyperthyroidism. Adv Neonatal Care 2003; 3: 272-82. [CrossRef ]
32. van der Kaay DC, Wasserman JD, Palmert MR. Management of neonates born to mothers with Graves' disease. Pediatrics 2016; 137(4). pii: e20151878. [CrossRef ]
33. Rivkees SA, Stephenson K, Dinauer C. Adverse events associated with methimazole therapy of graves' disease in children. Int J Pediatr Endocrinol 2010; 2010: 176970. [CrossRef ]
34. Peter F, Kalmar A, Kuesera R, et al. Human immunoglobulin therapy in serious neonatal Graves' disease. Long term (9 years) follow up. Horm Res 2005; 64: 249-50.
35. Wit JM, Gerards LJ, Vermeulen-Meiners C, Bruinse HW. Neonatal thyrotoxicosis treated with exchange transfusion and Lugol's iodine. Eur J Pediatr 1985; 143: 317-9. [CrossRef ]
36. Messer PM, Hauffa BP, Olbricht T, Benker G, Kotulla P, Reinwein D. Antithyroid drug treatment of Graves' disease in pregnancy: long-term effects on somatic growth, intellectual development and thyroid function of the offspring. Acta Endocrinol (Copenh) 1990; 123: 311-6. [CrossRef ]
37. Törnhage CJ, Grankvist K. Acquired neonatal thyroid disease due to TSH receptor antibodies in breast milk. J Pediatr Endocrinol Metab 2006; 19: 787-94. [CrossRef ]
38. Léger J, Olivieri A, Donaldson M, et al. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab 2014; 99: 363-84. [CrossRef ]
39. Kurtoğlu S, Akın L, Akın MA, Çoban D. Iodine overload and severe hypothyroidism in two neonates. J Clin Res Pediatr Endocrinol 2009; 1: 275-7. [CrossRef ]
40. Bryant WP, Zimmerman D. Iodine-induced hyperthyroidism in a newborn. Pediatrics 1995; 95: 434-6.
41. Duprez L, Parma J, Van Sande J, et al. Germline mutations in the thyrotropin receptor gene cause non-autoimmune autosomal dominant hyperthyroidism. Nat Genet 1994; 7: 396-401. [CrossRef ]
42. Kopp P, Muirhead S, Jourdain N, Gu WX, Jameson JL, Rodd C. Congenital hyperthyroidism caused by a solitary toxic adenoma harboring a novel somaticmutation (serine281-->isoleucine) in the extracellular domain of the thyrotropin receptor. J Clin Invest 1997; 100: 1634-9. [CrossRef ]
43. Péter F, Muzsnai A. Congenital disorders of the thyroid: hypo/hyper. Endocrinol Metab Clin North Am 2009; 38: 491-507. [CrossRef ]
44. Yoshimoto M, Nakayama M, Baba T, et al. A caseof neonatal McCune-Albright syndrome with Cushing syndrome and hyperthyroidism. Acta Paediatr Scand 1991; 80: 984-7. [CrossRef ]
45. Shenker A, Weinstein LS, Moran A, et al. Severe endocrine and nonendocrine manifestations of the McCuneAlbright syndrome associated with activating mutations of stimulatory G protein GS. J Pediatr 1993; 123: 509-18. [CrossRef ]
46. Blair JC, Mohan U, Larcher VF, et al. Neonatal thyrotoxicosis and maternal infertility in thyroid hormone resistance due to a mutation in the TRbeta gene (M313T). Clin Endocrinol (Oxf ) 2002; 57: 405-9. [CrossRef ]
47. Bulow Pedersen I, Laurberg P. Biochemical hyperthyroidism in anewborn baby by interaction from biotin intake. Eur Throid J 2016; 5: 212-5. [CrossRef ]
48. Momotani N, Noh JY, Ishikawa N, Ito K. Effects of propylthiouracil and methimazole on fetal thyroid status in mothers with Graves' hyperthyroidism. J Clin Endocrinol Metab 1997; 82: 3633-6. [CrossRef ]
49. Kempers MJ, van Tijn DA, van Trotsenburg AS, de Vijlder JJ, Wiedijk BM, Vulsma T. Central congenital hypothyroidism due to gestational hyperthyroidism: detection where prevention failed. J Clin Endocrinol Metab 2003; 88: 5851-7. [CrossRef ]
50. Higuchi R, Kumagai T, Kobayashi M, Minami T, Koyama H, Ishii Y. Short-termhyperthyroidism followed by transient pituitary hypothyroidism in a very lowbirth weight infant born to a mother with uncontrolled Graves' disease. Pediatrics 2001; 107: E57. [CrossRef ]

APA	Kurtoğlu S, ÖZDEMİR A (2017). Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. , 1 - 9.
Chicago	Kurtoğlu Selim,ÖZDEMİR Ahmet Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. (2017): 1 - 9.
MLA	Kurtoğlu Selim,ÖZDEMİR Ahmet Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. , 2017, ss.1 - 9.
AMA	Kurtoğlu S,ÖZDEMİR A Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. . 2017; 1 - 9.
Vancouver	Kurtoğlu S,ÖZDEMİR A Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. . 2017; 1 - 9.
IEEE	Kurtoğlu S,ÖZDEMİR A "Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları." , ss.1 - 9, 2017.
ISNAD	Kurtoğlu, Selim - ÖZDEMİR, Ahmet. "Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları". (2017), 1-9.

APA	Kurtoğlu S, ÖZDEMİR A (2017). Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. Türk Pediatri Arşivi, 52(1), 1 - 9.
Chicago	Kurtoğlu Selim,ÖZDEMİR Ahmet Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. Türk Pediatri Arşivi 52, no.1 (2017): 1 - 9.
MLA	Kurtoğlu Selim,ÖZDEMİR Ahmet Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. Türk Pediatri Arşivi, vol.52, no.1, 2017, ss.1 - 9.
AMA	Kurtoğlu S,ÖZDEMİR A Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. Türk Pediatri Arşivi. 2017; 52(1): 1 - 9.
Vancouver	Kurtoğlu S,ÖZDEMİR A Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları. Türk Pediatri Arşivi. 2017; 52(1): 1 - 9.
IEEE	Kurtoğlu S,ÖZDEMİR A "Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları." Türk Pediatri Arşivi, 52, ss.1 - 9, 2017.
ISNAD	Kurtoğlu, Selim - ÖZDEMİR, Ahmet. "Fetus ve yenidoğanda hipertiroidi: tanı ve tedavi yaklaşımları". Türk Pediatri Arşivi 52/1 (2017), 1-9.