tailieunhanh - Báo cáo y học: "Different fetal-neonatal outcomes in siblings born to a mother with Graves-Basedow disease after total thyroidectomy: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Different fetal-neonatal outcomes in siblings born to a mother with Graves-Basedow disease after total thyroidectomy: a case series. | Zuppa et al. Journal of Medical Case Reports 2010 4 59 http content 4 1 59 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Different fetal-neonatal outcomes in siblings born to a mother with Graves-Basedow disease after total thyroidectomy a case series Antonio Alberto Zuppa Paola Sindico Sabrina Perrone Chiara Carducci Eleonora Antichi Giovanni Alighieri Francesco Cota Patrizia Papacci Maria Pia De Carolis Costantino Romagnoli Valentina Cardiello Abstract Introduction We describe three different fetal or neonatal outcomes in the offspring of a mother who had persistent circulating thyrotropin receptor antibodies despite having undergone a total thyroidectomy several years before. Case presentation The three different outcomes were an intrauterine death a mild and transient fetal and neonatal hyperthyroidism and a severe fetal and neonatal hyperthyroidism that required specific therapy. Conclusions The three cases are interesting because of the different outcomes the absence of a direct correlation between thyrotropin receptor antibody levels and clinical signs and the persistence of thyrotropin receptor antibodies several years after a total thyroidectomy. Introduction Hyperthyroidism occurs in to of pregnancies. In about 95 of cases it is due to Graves-Basedow disease. In can also be due to Hashimoto s thyroiditis or less frequently to toxic adenoma multinodular toxic goiter subacute or silent thyroiditis hydatidiform mole or choriocarcinoma 1-3 . Neonatal hyperthyroidism develops in about 1 to 2 of babies born to mothers suffering from Graves-Basedow disease or in a few cases from Hashimoto s thyroiditis 4 . Neonatal hyperthyroidism is usually a transient disorder. It rarely appears at birth it is more usual within the first week of life. Sometimes it can be lethal because of the development of heart failure 3 . It is usually caused by IgG antibodies stimulating the thyroid stimulating hormone TSH receptors of