{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T08:31:25Z","timestamp":1769070685340,"version":"3.49.0"},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2017-0425_s_999_w2aab3b7c23b1b6b1aab1c16b1Aa\">\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Neonatal hyperthyroidism is rare, seen in infants of mothers with Graves\u2019 disease (GD), with transplacental transfer of thyroid-stimulating hormone receptor (TSHR) antibodies (TRAbs). We describe a neonate with severe hyperthyroidism due to TRAbs, born to a mother with autoimmune hypothyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2017-0425_s_998_w2aab3b7c23b1b6b1aab1c16b2Aa\">\n                  <jats:title>Case presentation:<\/jats:title>\n                  <jats:p>A baby boy born preterm at 35 weeks had irritability, tachycardia and proptosis after birth. The mother had autoimmune hypothyroidism, from age 10, with thyroxine replacement and normal thyroid function throughout her pregnancy. She had never been thyrotoxic. There was a family history of Hashimoto\u2019s thyroiditis (HT) and GD. The baby\u2019s thyroid function on day 3 demonstrated gross thyrotoxicosis, TSH&lt;0.01 mIU\/L (normal range [NR]&lt;10 mIU\/L), free thyroxine (FT4)&gt;77 pmol\/L (20\u201335), free triiodothyronine (FT3) 15.4 pmol\/L (4.2\u20138.3) and TRAb 18.4 IU\/L (&lt;1.8). The mother\u2019s TRAb was 24.7 IU\/L. Thyrotoxicosis required propranolol and carbimazole (CBZ). Thyroid function normalized within 10 days. The baby was weaned off medication by 7 weeks. He remains euthyroid.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2017-0425_s_997_w2aab3b7c23b1b6b1aab1c16b3Aa\">\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>We postulate that this mother had co-existing destructive thyroiditis and thyroid-stimulating antibodies (TSAbs) and TSHR blocking antibodies (TBAb), rendering her unable to raise a thyrotoxic response to the TSAbs but with predominant TSAb transmission to her infant. Maternal history of any thyroid disorder may increase the risk of transmission to an infant, requiring a careful clinical assessment of the neonate, with important implications for future pregnancies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2017-0425","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T07:47:12Z","timestamp":1523519232000},"page":"577-580","source":"Crossref","is-referenced-by-count":10,"title":["Hyperthyroidism in an infant of a mother with autoimmune hypothyroidism with positive TSH receptor antibodies"],"prefix":"10.1515","volume":"31","author":[{"given":"Kriti","family":"Joshi","sequence":"first","affiliation":[{"name":"Murdoch Children\u2019s Research Institute , Parkville, Victoria , Australia"},{"name":"Department of Endocrinology , The Royal Children\u2019s Hospital , Parkville, Victoria , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Zacharin","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute , Parkville, Victoria , Australia"},{"name":"Department of Endocrinology , The Royal Children\u2019s Hospital , Parkville, Victoria , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"2021021322190342560_j_jpem-2017-0425_ref_001_w2aab3b7c23b1b6b1ab2b1b1Aa","doi-asserted-by":"crossref","unstructured":"van der Kaay DC, Wasserman JD, Palmert MR. Management of neonates born to mothers with Graves\u2019 disease. Pediatrics 2016;137:e20151878.","DOI":"10.1542\/peds.2015-1878"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_002_w2aab3b7c23b1b6b1ab2b1b2Aa","doi-asserted-by":"crossref","unstructured":"McLachlan SM, Rapoport B. Thyrotropin-blocking autoantibodies and thyroid-stimulating autoantibodies: potential mechanisms involved in the pendulum swinging from hypothyroidism to hyperthyroidism or vice versa. Thyroid 2013;23:14\u201324.","DOI":"10.1089\/thy.2012.0374"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_003_w2aab3b7c23b1b6b1ab2b1b3Aa","doi-asserted-by":"crossref","unstructured":"Takasu N, Yamada T, Takasu M, Komiya I, Nagasawa Y, et al. Disappearance of thyrotropin-blocking antibodies and spontaneous recovery from hypothyroidism in autoimmune thyroiditis. N Engl J Med 1992;326:513\u20138.","DOI":"10.1056\/NEJM199202203260803"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_004_w2aab3b7c23b1b6b1ab2b1b4Aa","doi-asserted-by":"crossref","unstructured":"Takasu N, Yamada T, Katakura M, Yamauchi K, Shimizu Y, et al. Evidence for thyrotropin (TSH)-blocking activity in goitrous Hashimoto\u2019s thyroiditis with assays measuring inhibition of TSH receptor binding and TSH-stimulated thyroid adenosine 3\u2032,5\u2032-monophosphate responses\/cell growth by immunoglobulins. J Clin Endocrinol Metab 1987;64:239\u201345.","DOI":"10.1210\/jcem-64-2-239"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_005_w2aab3b7c23b1b6b1ab2b1b5Aa","doi-asserted-by":"crossref","unstructured":"Takasu N, Matsushita M. Changes of TSH-stimulation blocking antibody (TSBAb) and thyroid stimulating antibody (TSAb) over 10 years in 34 TSBAb-positive patients with hypothyroidism and in 98 TSAb-positive Graves\u2019 patients with hyperthyroidism: reevaluation of TSBAb and TSAb in TSH-receptor-antibody (TRAb)-positive patients. J Thyroid Res 2012;2012:182176.","DOI":"10.1155\/2012\/182176"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_006_w2aab3b7c23b1b6b1ab2b1b6Aa","doi-asserted-by":"crossref","unstructured":"Takasu N, Yamada T, Sato A, Nakagawa M, Komiya I, et al. Graves\u2019 disease following hypothyroidism due to Hashimoto\u2019s disease: studies of eight cases. Clin Endocrinol (Oxf) 1990; 33:687\u201398.","DOI":"10.1111\/j.1365-2265.1990.tb03906.x"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_007_w2aab3b7c23b1b6b1ab2b1b7Aa","unstructured":"Kohn LD, Suzuki K, Hoffman WH, Tombaccini D, Marcocci C, et al. Characterization of monoclonal thyroid-stimulating and thyrotropin binding-inhibiting autoantibodies from a Hashimoto\u2019s patient whose children had intrauterine and neonatal thyroid disease. J Clin Endocrinol Metab 1997;82:3998\u20134009."},{"key":"2021021322190342560_j_jpem-2017-0425_ref_008_w2aab3b7c23b1b6b1ab2b1b8Aa","unstructured":"Chang TC, Lee JS. Pregnancy induces the presence of a thyroid-stimulating antibody in a thyrotropin-binding inhibitory immunoglobulin positive, hypothyroid woman with transient thyrotoxicosis in offspring. J Formos Med Assoc 1990;89: 709\u201313."},{"key":"2021021322190342560_j_jpem-2017-0425_ref_009_w2aab3b7c23b1b6b1ab2b1b9Aa","doi-asserted-by":"crossref","unstructured":"Lu R, Burman KD, Jonklaas J. Transient Graves\u2019 hyperthyroidism during pregnancy in a patient with Hashimoto\u2019s hypothyroidism. Thyroid 2005;15:725\u20139.","DOI":"10.1089\/thy.2005.15.725"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_010_w2aab3b7c23b1b6b1ab2b1c10Aa","unstructured":"Volpe R, Ehrlich R, Steiner G, Row VV. Graves\u2019 disease in pregnancy years after hypothyroidism with recurrent passive-transfer neonatal Graves\u2019 disease in offspring. Therapeutic considerations. Am J Med 1984;77:572\u20138."},{"key":"2021021322190342560_j_jpem-2017-0425_ref_011_w2aab3b7c23b1b6b1ab2b1c11Aa","doi-asserted-by":"crossref","unstructured":"Brookfield DS, McCandless AE, Smith CS. Thyrotoxicosis in a neonate of a mother with no history of thyroid disease. Arch Dis Child 1976;51:314\u20136.","DOI":"10.1136\/adc.51.4.314"},{"key":"2021021322190342560_j_jpem-2017-0425_ref_012_w2aab3b7c23b1b6b1ab2b1c12Aa","unstructured":"Kiefer FW, Klebermass-Schrehof K, Steiner M, Worda C, Kasprian G, et al. Fetal\/neonatal thyrotoxicosis in a newborn from a hypothyroid woman with Hashimoto thyroiditis. J Clin Endocrinol Metab 2017;102:6\u20139."}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/jpem.2018.31.issue-5\/jpem-2017-0425\/jpem-2017-0425.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2017-0425\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2017-0425\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T01:43:23Z","timestamp":1619055803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2017-0425\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,1]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,3,1]]},"published-print":{"date-parts":[[2018,5,24]]}},"alternative-id":["10.1515\/jpem-2017-0425"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2017-0425","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2018,3,1]]}}}