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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(02): e176-e183
DOI: 10.1055/a-2317-9431
Case Report

Fetal Hyperthyroidism Secondary to Maternal Basedow–Graves' Disease

Julio Soto 
1   Department of Pediatrics, School of Medicine, Universidad de Concepcion, Concepcion, Chile
2   Division of Pediatric Endocrinology, Pediatrics Service, Hospital Las Higueras, Talcahuano, Chile
,
Bunio Weissglas
3   Department of Internal Medicine, School of Medicine, Universidad de Concepcion, Concepcion, Chile
,
Gustav von Plessing-Pierry 
3   Department of Internal Medicine, School of Medicine, Universidad de Concepcion, Concepcion, Chile
,
Maria Paz del Solar
4   Department of Clinical and Preclinical Sciences, School of Medicine, Universidad Catolica de la Santisima Concepcion, Concepcion, Chile
,
Carolina Peña-Villa
3   Department of Internal Medicine, School of Medicine, Universidad de Concepcion, Concepcion, Chile
5   Division of Endocrinology, Internal Medicine Service, Hospital Las Higueras, Talcahuano, Chile
,
Ximena Flores
6   Division of Obstetric and Gynecologic Ultrasound, Obstetrics and Gynecology Service, Hospital Las Higueras, Talcahuano, Chile
7   Department of Obstetrics and Ginecology, School of Medicine, Universidad de Concepcion, Concepcion, Chile
,
Monica Arancibia
2   Division of Pediatric Endocrinology, Pediatrics Service, Hospital Las Higueras, Talcahuano, Chile
,
Laura Campos
2   Division of Pediatric Endocrinology, Pediatrics Service, Hospital Las Higueras, Talcahuano, Chile
› Author Affiliations Funding None.
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Abstract

Fetal hyperthyroidism is a rare prenatal disease and can be life-threatening. The diagnosis is based on ultrasound in mothers with a history of Basedow–Graves' disease and elevation of thyrotropin receptor antibodies (TRAbs) levels. The treatment consists of antithyroid drugs. We present a mother with Basedow–Graves' disease, treated with radioactive iodine 16 years ago. She had an unplanned pregnancy at the age of 29 years, and an elevation of TRAbs (21 U/L) was found at the sixth week of pregnancy. At 22 weeks of gestation, fetal ultrasound displayed tachycardia, goiter, exophthalmos, and suspicion of craniosynostosis, hence methimazole was started. Concomitantly, suppressed maternal thyroid-stimulating hormone (TSH) was found. Her daughter was born at 33 + 6 weeks showing clinical and laboratory findings of hyperthyroidism. Consequently, treatment with methimazole was prescribed. Normal thyroid function was documented in the mother after giving birth. Clear explanation has not been found for the alteration of maternal TSH during pregnancy.

Keywords

fetal hyperthyroidism - Graves' disease - hyperthyroidism - fetal


Publication History

Received: 12 October 2022

Accepted: 10 April 2024

Accepted Manuscript online:
02 May 2024

Article published online:
31 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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