Central Hypothyroidism with Severely Delayed Myelination in a Boy Born to a Mother with Untreated Graves’ Disease

Abstract

We report a 2-year old boy with central hypothyroidism accompanied by delayed myelination, born to a mother with untreated Graves’ disease. His mother was diagnosed as having Graves’ disease 6 days after delivery. At 3 months of age he was diagnosed as having central hypothyroidism, and L-thyroxine replacement therapy was started. His psychomotor development was delayed and magnetic resonance imaging of the brain showed severely delayed myelination. At 2 years of age serum thyrotropin responses to thyrotropin-releasing hormone were still blunted. Whether his central hypothyroidism is permanent or ultimately reversible remains to be determined, but it is possible that hypothyroxinemia in the neonatal period may interrupt the myelination of the brain.