Transient Central Hypothyroidism Due to Pituitary Suppression in a Premature Neonate Born to a Mother with Three-Year-Untreated Graves' Disease

Abstract

Several types of transient thyroid dysfunction in infants born to mothers with Graves' disease have been described, ranging from completely unaffected infants to those with hyperthyroidism or hypothyroidism, depending on maternal thyroid function, activity of maternal TSH receptor antibody (TRAb) and maternal antithyroid agents due to transplacental passage. We observed a premature neonate born to a mother with three-year-untreated Graves' disease, who developed transient central hypothyroidism in the immediate postnatal period. Placental transfer of thyroxine and TRAb from the thyrotoxic mother may cause fetal peripheral thyrotoxicosis resulting in suppression of the fetal pituitary-thyroid axis.