Published online April 15, 2005
PEDIATRICS Vol. 115 No. 5 May 2005, pp. e623-e625 (doi:10.1542/peds.2004-2128)
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ELECTRONIC ARTICLE

Central Hypothyroidism in Infants Who Were Born to Mothers With Thyrotoxicosis Before 32 Weeks' Gestation: 3 Cases

Ryuzo Higuchi, PhD*, Masakazu Miyawaki, MD{ddagger}, Takeshi Kumagai, MD§, Takahiro Okutani, PhD*, Yuko Shima, MD{ddagger}, Megumi Yoshiyama, MD{ddagger}, Hiroshi Ban, MD|| and Norisige Yoshikawa, PhD{ddagger}

* Departments of Perinatal Medicine
{ddagger} Pediatrics, Wakayama Medical University, Wakayama, Japan
§ Department of Neonatology, Tokushukai Hospital at Kishiwada, Osaka, Japan
|| Department of Pediatrics, Kinan General Hospital, Tanabe, Japan

We describe 3 infants who were born to mothers with Graves' disease and developed central hypothyroidism that persisted for >6 months after birth. Two were preterm infants, and the other was a term infant who was born to a euthyroid mother who had been treated with an antithyroid drug since week 31 of gestation. These cases suggest that passage of thyroid hormones can occur from a thyrotoxic mother to the fetus and that the gestational period earlier than 32 weeks may be the critical time for development of central hypothyroidism.

Key Words: central hypothyroidism • Graves' disease • midgestation • preterm infant • thyrotoxicosis

Abbreviations: T4, thyroxine • TSH, thyrotropin • T3, triiodothyronine • FT4, free T4 • TRAb, TSH receptor antibody • TSAb, thyroid-stimulating antibody • FT3, free T3 • TRH, thyrotropin-releasing hormone; GnPn, gravida n, para n

Accepted Dec 2, 2004.


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