welcome to oneGRAVESvoice
- a positively charged Graves' disease and thyroid eye disease community.- join today!
- log in
Management of Fetal and Neonatal Graves’ Disease
source: Hormone Research in Pædiatrics
year: 2017
authors: Léger J
summary/abstract:Fetal and neonatal autoimmune hyperthyroidism is a rare, serious but transient disorder. Early diagnosis and treatment are key objectives for an optimal prognosis and the well-being of the child. This review focuses on the management of these patients during the fetal and neonatal periods. We propose a diagnostic algorithm for high-risk pregnancies in mothers with current or past hyperthyroidism related to Graves’ disease, involving repeated fetal thyroid gland assessments from 20 weeks of gestation onwards and maternal serum thyroid-stimulating hormone receptor antibody (TRAb) determination, with close monitoring if TRAb levels exceed 2 to 3 times the upper limit of the normal range.
In fetuses with goiter, the main clinical issue is determining whether the cause is maternal antithyroid drug (ATD) treatment that is appropriate for achieving normal maternal thyroid function but inappropriate and excessive for the fetus, resulting in hypothyroidism and necessitating a decrease in the ATD dose during pregnancy, or the presence of TRAbs resulting in fetal thyroid stimulation and hyperthyroidism, requiring an increase in the maternal ATD dose.
Methimazole/carbimazole treatment should be initiated as soon as possible during the neonatal period, carefully managed and maintained over a period of 1-3 months and then stopped when TRAb is no longer detectable in serum.
organization: Hôpital Robert Debré, France; Université Paris Diderot, France; Sorbonne Paris Cité, France; Institut National de la Santé et de la Recherche Médicale (INSERM), FranceDOI: 10.1159/000453065
full text source
rareRelated
-
Vitamin D and Graves’ Disease: A Meta-Analysis UpdateThe association between vitamin D levels...
-
Racial Disparities in Thyroid Surgery: Summary for the PublicBackground: Recent protests over police...
-
Nicholas Robert Mahoney, MDNicholas Robert Mahoney is an Associate ...
-
TEPEZZA (teprotumumab-trbw)- Frequently Asked Questions1. What is TEPEZZA? TEPEZZA is the firs...
-
Preventing Postoperative Hypocalcemia in Patients With Graves’ Disease: A Prospective StudyBackground: Hypocalcemia occurs after t...
-
Current Diagnosis and Management of Graves’ Disease.Graves' disease is an autoimmune disorde...
-
Kyle Godfrey, MDKyle J. Godfrey, M.D. is an Assistant Pr...