Skip to main content

Neonatal Graves’ Disease

  • Chapter
Graves’ Disease

Part of the book series: Endocrine Updates ((ENDO,volume 6))

  • 324 Accesses

Abstract

The syndrome that is now commonly called neonatal Graves’ disease, i.e., hyperthyroidism of limited duration and occasionally associated with goiter and ophthalmopathy, was first reported in 1910 (1), followed by a case presentation in 1912 (2). Until 1974 an additional 75 cases were described (3) and since then the number has approximately doubled. As can be seen, the condition is not common. Considering that Graves’ disease occurs in about 0.2% of pregnant women (4) and overt thyrotoxicosis in approximately 2% of their offspring (4,5), the overall prevalence is of the order of 1 per 25,000 neonates (4) or even, as estimated by Fisher (6), 1 per 200,000. Still, the timely diagnosis of the syndrome is very important, since it can have dire consequences if left untreated (3,7).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Schmauch, quoted by Ochner AJ, Thompson RL. 1910 The surgery and pathology of the thyroid and parathyroid glands. St. Louis: Mosby; p 192.

    Google Scholar 

  2. White C. 1912 A foetus with congenital hereditary Graves’ disease. J Obstet Gynaec Brit Emp. 21:231.

    Article  Google Scholar 

  3. Hollingsworth DR, Mabry CC. 1976 Congenital Graves’ disease. Four familial cases with long-term follow-up and perspective. Am J Dis Child. 130:148–155.

    PubMed  CAS  Google Scholar 

  4. Burrow GN. 1985 The management of thyrotoxicosis in pregnancy. N Engl J Med. 313:562–565.

    Article  PubMed  CAS  Google Scholar 

  5. Mitsuda N, Tamaki H, Amino N, Hosono T, Miyai K, Tanizawa O. 1992 Risk factors for developmental disorders in infants born to women with Graves disease. Obstet Gynecol. 80:359–364.

    PubMed  CAS  Google Scholar 

  6. Fisher DA. 1997 Fetal thyroid function: diagnosis and management of fetal thyroid disorders. Clin Obstet Gynecol. 40:16–31.

    Article  PubMed  CAS  Google Scholar 

  7. Daneman D, Howard NJ. 1980 Neonatal thyrotoxicosis: intellectual impairment and craniosynostosis in later years. J Pediatr. 97:257–259.

    Article  PubMed  CAS  Google Scholar 

  8. Adams DD, Purves HD. 1956 Abnormal responses in the assay of thyrotrophin. Proc Univ Otago Med Sch. 34:11–12.

    Google Scholar 

  9. McKenzie JM. 1964 Neonatal Graves’ disease. J Clin Endocrinol Metab. 24:660–668.

    Article  PubMed  CAS  Google Scholar 

  10. Adams DD, Lord JM, Stevely HAA. 1964 Congenital thyrotoxicosis. Lancet. 2:497–498.

    Article  PubMed  CAS  Google Scholar 

  11. Sunshine P, Kusumoto H, Kriss JP. 1965 Survival time of circulating long-acting thyroid stimulator in neonatal thyrotoxicosis: implications for diagnosis and therapy of the disorder. Pediatrics. 36:869–876.

    PubMed  CAS  Google Scholar 

  12. Adams DD, Kennedy TH. 1967 Occurrence in thyrotoxicosis of a gamma globulin which protects LATS from neutralization by an extract of thyroid gland. J Clin Endocrinol Metab. 27:173–177.

    Article  PubMed  CAS  Google Scholar 

  13. Dirmikis SM, Munro DS. 1975 Placental transmission of thyroid-stimulating immunoglobins. Br Med J. 2:665–666.

    Article  PubMed  CAS  Google Scholar 

  14. McKenzie JM, Zakarija M. 1996 Antibodies in autoimmune thyroid disease. In: Braverman LE, Utiger RD, eds. The Thyroid. 7th ed. New York: Lippincott-Raven; 416–432.

    Google Scholar 

  15. McKenzie JM, Zakarija M. 1978 Pathogenesis of neonatal Graves’ disease. J Endocrinol Invest. 2:183–189.

    Google Scholar 

  16. Zakarija M, McKenzie JM. 1983 Pregnancy-associated changes in the thyroid-stimulating antibody of Graves’ disease and the relationship to neonatal hyperthyroidism. J Clin Endocrinol Metab. 57:1036–1040.

    Article  PubMed  CAS  Google Scholar 

  17. Rapoport B, Greenspan FS, Filetti S, Pepitone M. 1984 Clinical experience with a human thyroid cell bioassay for thyroid-stimulating immunoglobulins. J Clin Endocrinol Metab. 58:332–338.

    Article  PubMed  CAS  Google Scholar 

  18. Zakarija M, Garcia A, McKenzie JM. 1985 Studies on multiple thyroid cell membrane-directed antibodies in Graves’ disease. J Clin Invest. 76:1885–1891.

    Article  PubMed  CAS  Google Scholar 

  19. Zakarija M, McKenzie JM, Eidson MS. 1990 Transient neonatal hypothyroidism: characterization of maternal antibodies to the thyrotropin receptor. J Clin Endocrinol Metab. 70:1239–1246.

    Article  PubMed  CAS  Google Scholar 

  20. Nagayama Y, Rapoport B. 1992 Thyroid stimulatory antibodies in different patients with autoimmune thyroid disease do not all recognize the same components of the human thyrotropin receptor: selective role of amino acids Ser25 - Glu30. J Clin Endocrinol Metab. 75: 1425–1430.

    Article  PubMed  CAS  Google Scholar 

  21. Kosugi S, Ban T, Akamizu T, Valente W, Kohn LD. 1993 Use of thyrotropin receptor (TSHR) mutants to detect stimulating TSHR antibodies in hypothyroid patients with idiopathic myxedema, who have blocking TSHR antibodies. J Clin Endocrinol Metab. 77:19–24.

    Article  PubMed  CAS  Google Scholar 

  22. Watanabe Y, Tahara K, Hirai A, Tada H, Kohn LD, Amino N. 1997 Subtypes of anti-TSH receptor antibodies classified by bio- and conversion assays using CHO cells expressing wild type human TSH receptor or TSH receptor-LH/CG receptor chimera. Thyroid. 7:13–19.

    Article  PubMed  CAS  Google Scholar 

  23. McKenzie JM, Zakarija M. 1992 Fetal and neonatal hyperthyroidism and hypothyroidism due to maternal TSH receptor antibodies. Thyroid. 2:155–159.

    Article  PubMed  CAS  Google Scholar 

  24. Van Sande J, Parma J, Tonacchera M, Dumont J, Vassart G. 1995 Somatic and germline mutations of the TSH receptor gene in thyroid disease. J Clin Endocrinol Metab. 80:2577–2585.

    Article  PubMed  Google Scholar 

  25. Duprez L, Parma J, Van Sande J, et al. 1994 Germline mutations in the thyrotropin receptor gene cause non-autoimmune autosomal dominant hyperthyroidism. Nature Genet. 7:396–401.

    Article  PubMed  CAS  Google Scholar 

  26. Kopp P, Van Sande J, Parma J, et al. 1995 Brief report: Congenital hyperthyroidism caused by a mutation in the thyrotropin receptor gene. N Engl J Med. 332:150–154.

    Article  PubMed  CAS  Google Scholar 

  27. De Roux N, Polak M, Couet J, et al. 1996 A neomutation of the thyroid-stimulating hormone receptor in a severe neonatal hyperthyroidism. J Clin Endocrinol Metab. 81:2023–2026.

    Article  PubMed  Google Scholar 

  28. Kopp P, Muirhead S, Jourdain N, Gu W-X, Jameson JL, Rodd C. 1997 Congenital hyperthyroidism caused by a solitary toxic adenoma harboring a novel somatic mutation (serine 281 → isoleucine) in the extracellular domain of the thyrotropin receptor. J Clin Invest. 100:1634–1639.

    Article  PubMed  CAS  Google Scholar 

  29. Valyasevi RW, Ericson DZ, Harteneck DA, et al. 1999 Differentiation of human orbital preadipocyte fibroblasts induces expression of functional thyrotropin receptor. J Clin Endocrinol Metab. 84:2557–2562.

    Article  PubMed  CAS  Google Scholar 

  30. Thorpe-Beeston JG, Nicolaides KH, McGregor AM. 1992 Fetal thyroid function. Thyroid. 2:207–217.

    Article  PubMed  CAS  Google Scholar 

  31. Stites DP. 1980 Clinical laboratory methods for detection of antigens & antibodies. In: Fudenberg HH, Stites DP, Caldwell JL, Wells JV, eds. Basic & clinical immunology. 3rd ed. Los Altos, California: Lange Medical Publishers; 343–381.

    Google Scholar 

  32. Sarvas H, Seppala I, Kurikka S, Siegberg R, Makela O. 1993 Half-life of the maternal IgG1 allotype in infants. J Clin Immunol. 13:145–151.

    Article  PubMed  CAS  Google Scholar 

  33. Hunt JS. 1992 Immunobiology of pregnancy. Curr Opin Immunol. 4:591–596.

    Article  PubMed  CAS  Google Scholar 

  34. Sargent IL. 1993 Maternal and fetal immune responses during pregnancy. Exp Clin Immunogenet. 10:85–102.

    PubMed  CAS  Google Scholar 

  35. Medina KL, Smithson G, Kincade PW. 1993 Suppression of B lymphopoeisis during normal pregnancy. J Exp Med. 178:1507–1515.

    Article  PubMed  CAS  Google Scholar 

  36. Iwatani Y, Amino N, Tachi J, et al. 1988 Changes in lymphocyte subsets in normal pregnant women and postpartum women: postpartum increase of NK/K (Leu 7) cells. Am J Reproduct Immunol. 18:52–55.

    CAS  Google Scholar 

  37. Stagnaro-Green A, Roman SH, Cobin RH, El-Harazy E, Wallenstein S, Davies TF. 1992 A prospective study of lymphocyte-initiated immunosuppression in normal pregnancy: evidence of a T-cell etiology for postpartum thyroid dysfunction. J Clin Endocrinol Metab. 74:645–653.

    Article  PubMed  CAS  Google Scholar 

  38. Amino N, Kuro R, Tanizawa O, et al. 1978 Changes of serum anti-thyroid antibodies during and after pregnancy in autoimmune thyroid disease. Clin Exp Immunol. 31:30–37.

    PubMed  CAS  Google Scholar 

  39. Volpe R, Ehrlich R, Steiner G, Row VV. 1984 Graves’ disease in pregnancy years after hypothyroidism with recurrent passive-transfer neonatal Graves’ disease in offspring. Therapeutic considerations. Am J Med. 77:572–578.

    Article  PubMed  CAS  Google Scholar 

  40. Wenstrom KD, Weiner CP, Williamson RA, Grant SS. 1990 Prenatal diagnosis of fetal hyperthyroidism using funipuncture. Obstet Gynecol. 76:513–517.

    PubMed  CAS  Google Scholar 

  41. Porreco RP, Bloch CA. 1990 Fetal blood sampling in the management of intrauterine thyrotoxicosis. Obstet Gynecol. 76:509–512.

    PubMed  CAS  Google Scholar 

  42. Hadi HA, Strickland D. 1995 Prenatal diagnosis and management of fetal goiter caused by maternal Graves’ disease. Am J Perinat. 12:240–242.

    Article  CAS  Google Scholar 

  43. Watson WJ, Fiegen MM. 1995 Fetal thyrotoxicosis associated with nonimmune hydrops. Am J Obstet Gynecol. 172:1039–1040.

    Article  PubMed  CAS  Google Scholar 

  44. Wallace C, Couch R., Ginsberg J. 1995 Fetal thyrotoxicosis: a case report and recommendations for prediction, diagnosis, and treatment. Thyroid 5:125–128.

    Article  PubMed  CAS  Google Scholar 

  45. Rakover Y, Weiner E, Mosh N, Shalev E. 1999 Fetal pituitary negative feedback at early gestational age. Clin Endocrinol. 50:809–814.

    Article  CAS  Google Scholar 

  46. Robinson PL, O’Mullane NM, Alderman B. 1979 Prenatal treatment of fetal thyrotoxicosis. Br Med J. 1:383–384.

    Article  PubMed  CAS  Google Scholar 

  47. Serup J, Petersen S. 1979 Fetal thyrotoxicosis in utero. Biol Neonate. 35:175–179.

    Article  PubMed  CAS  Google Scholar 

  48. Cove DH, Johnston P. 1985 Fetal hyperthyroidism: experience of treatment in four siblings. Lancet. 1:430–432.

    Article  PubMed  CAS  Google Scholar 

  49. Houck JA, Davis RE, Sharma HM. 1988 Thyroid-stimulating immunoglobulin as a cause of recurrent intrauterine fetal death. Obstet Gynecol. 71:1018–1019.

    PubMed  CAS  Google Scholar 

  50. Treadwell MC, Sherer DM, Sacks AJ, Ghezzi F, Romero R. 1996 Successful treatment of recurrent non-immune hydrops secondary to fetal hyperthyroidism. Obstet Gynecol. 87:838–840.

    PubMed  CAS  Google Scholar 

  51. Check JH, Rezvani I, Goodner D, Hopper B. 1982 Prenatal treatment of thyrotoxicosis to prevent intrauterine growth retardation. Obstet Gynecol. 60:122–124.

    PubMed  CAS  Google Scholar 

  52. Zakarija M, McKenzie JM, Hoffman WH. 1986 Prediction and therapy of intrauterine and late-onset neonatal hyperthyroidism. J Clin Endocrinol Metab. 62:368–371.

    Article  PubMed  CAS  Google Scholar 

  53. Momotani N, Noh J, Oyanagi H, Ishikawa N, Ito K. 1986 Antithyroid drug therapy for Graves’ disease during pregnancy. Optimal regimen for fetal thyroid status. N Engl J Med. 315:24–28.

    Article  PubMed  CAS  Google Scholar 

  54. Gardner DF, Cruikshank DP, Hays PM, Cooper DS. 1986 Pharmacology of propylthiouracil (PTU) in pregnant hyperthyroid women: correlation of maternal PTU concentrations with cord serum thyroid function tests. J Clin Endocrinol Metab. 62:217–220.

    Article  PubMed  CAS  Google Scholar 

  55. Davidson KM, Richards DS, Schatz DA, Fisher DA. Successful in utero treatment of fetal goiter and hypothyroidism. 1991 N Engl J Med. 324:543–546.

    Article  PubMed  CAS  Google Scholar 

  56. Van Loon AJ, Derksen JThM, Bos AF, Rouwe CW. 1995 In utero diagnosis and treatment of fetal goitrous hypothyroidism, caused by maternal use of propylthiouracil. Prenat Diagn. 15:599–604.

    Article  PubMed  Google Scholar 

  57. Cheron RG, Kaplan MM, Larsen PR, Selenkow HA, Crigler JF. 1981 Neonatal thyroid function after propylthiouracil therapy for maternal Graves’ disease. N Engl J Med. 304:525–528.

    Article  PubMed  CAS  Google Scholar 

  58. Eisenstein Z, Weiss M, Katz Y, Bank H. 1992 Intellectual capacity of subjects exposed to methimazole or propylthiouracil in utero. Eur J Pediatr. 151:558–559.

    Article  PubMed  CAS  Google Scholar 

  59. McKenzie JM, Zakarija M. 1989 Clinical review 3. The clinical use of thyrotropin receptor antibody measurements. J Clin Endocrinol Metab. 69:1093–1096.

    Article  PubMed  CAS  Google Scholar 

  60. Tamaki H, Amino N, Iwatani Y, et al. 1989 Evaluation of TSH receptor antibody by “natural in vivo human assay” in neonates born to mothers with Graves’ disease. Clin Endocrinol. 30:493–503.

    Article  CAS  Google Scholar 

  61. Mortimer RH, Tyack SA, Galligan JP, Perry-Keene DA, Tan YM. 1990 Graves’ disease in pregnancy: TSH receptor binding inhibiting immunoglobulins and maternal and neonatal thyroid function. Clin Endocrinol. 32:141–152.

    Article  CAS  Google Scholar 

  62. Kohn LD, Suzuki K, Hoffman WH, et al. 1997 Characterization of monoclonal thyroid-stimulating and thyrotropin binding-inhibiting autoantibodies from a Hashimoto’s patient whose children had intrauterine and neonatal thyroid disease, j Clin Endocrinol Metab. 82:3998–4009.

    Article  PubMed  CAS  Google Scholar 

  63. Zakarija M, McKenzie JM, Munro DS. 1983 Immunoglobulin G inhibitor of thyroid-stimulating antibody is a cause of delay in the onset of neonatal Graves’ disease. J Clin Invest. 72:1352–1356.

    Article  PubMed  CAS  Google Scholar 

  64. Hoffman WH, Sahasrananan P, Ferandos SS, Burek CL, Rose NR. 1982 Transient thyrotoxicosis in an infant delivered to a long-acting thyroid stimulator (LATS)- and LATS protector-negative, thyroid-stimulating antibody-positive women with Hashimoto’s thyroiditis. 1982 J Clin Endocrinol Metab. 54:354–356.

    Article  PubMed  CAS  Google Scholar 

  65. Dean H J, Zakarija M. 1986 Delayed onset of neonatal thyrotoxicosis may be caused by an inhibitor of thyroid stimulating antibody. Annual Meeting, Canadian Society for Clinical Investigation, Toronto, September.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer Science+Business Media New York

About this chapter

Cite this chapter

Zakarija, M., McKenzie, J.M. (2000). Neonatal Graves’ Disease. In: Rapoport, B., McLachlan, S.M. (eds) Graves’ Disease. Endocrine Updates, vol 6. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4407-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-4407-4_15

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6983-7

  • Online ISBN: 978-1-4615-4407-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics