{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:11:54Z","timestamp":1761675114507,"version":"3.40.5"},"reference-count":6,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,4,1]]},"abstract":"<jats:p>Transient hypothyroxinemia in infants born to mothers with poorly controlled Graves' disease was first reported in 1988. We report that short-term hyperthyroidism followed by hypothyroidism with low basal thyroid-stimulating hormone (TSH) levels developed in a very low birth weight infant born at 27 weeks of gestation to a noncompliant mother with thyrotoxicosis attributable to Graves' disease. We performed serial thyrotropin-releasing hormone (TRH) tests in this infant and demonstrated that TSH unresponsiveness to TRH disappeared at 6.5 months of age.<\/jats:p><jats:p>The maternal thyroid function was free triiodothyronine (FT3), 21.1 pg\/mL; free thyroxine (FT4), 8.1 ng\/dL; TSH, &amp;lt;0.03 \u03bcU\/mL; thyroid-stimulating hormone receptor antibody, 52% (normal: &amp;lt;15%); thyroid-stimulating antibody, 294% (normal: &amp;lt;180%); and thyroid-stimulation blocking antibody, 9% (normal: &amp;lt;25%) on the day of delivery. A nonstress test revealed fetal tachycardia &amp;gt;200 beats per minute, and a male infant weighing 1152 g was born by emergency cesarean section. Thyroid-stimulating hormone receptor antibody was 16% and thyroid-stimulating antibody was 370% in the cord blood. We administered 10 mg\/kg per day of oral propylthiouracil from day 1. Tachycardia along with elevated FT4 and FT3 levels in the infant decreased from 200\/minute to 170\/minute, 4.7 ng\/dL to 2.9 ng\/dL, 7.0 pg\/mL to 4.8 pg\/mL, respectively, in the first 33 hours. At 5 days, FT4and FT3 were 1.1 ng\/dL and 2.9 pg\/mL, respectively, and we stopped propylthiouracil administration. Although FT4decreased to 0.4 ng\/dL, TSH was quite low and did not respond to intravenous TRH by 14 days of age. We began daily levothyroxine 5-\u03bc\/kg supplementation. The responsiveness of TSH to TRH did not become significant until 4 months old and normalized at 6.5 months old. At this time, levothyroxine was stopped.<\/jats:p><jats:p>We conclude that placental transfer of thyroid hormones may cause hyperthyroidism in the fetal and early neonatal periods and lead to transient pituitary hypothyroidism in an infant born to a mother with uncontrolled Graves' disease.<\/jats:p>","DOI":"10.1542\/peds.107.4.e57","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"e57-e57","source":"Crossref","is-referenced-by-count":20,"title":["Short-Term Hyperthyroidism Followed by Transient Pituitary Hypothyroidism in a Very Low Birth Weight Infant Born to a Mother With Uncontrolled Graves' Disease"],"prefix":"10.1542","volume":"107","author":[{"given":"Ryuzo","family":"Higuchi","sequence":"first","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kumagai","sequence":"additional","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaomi","family":"Minami","sequence":"additional","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Koyama","sequence":"additional","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Ishii","sequence":"additional","affiliation":[{"name":"1 From the Department of Perinatal Medicine, Wakayama Medical College, Wakayama City, 641-0012, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2001,4,1]]},"reference":[{"key":"2021121003434907500_B1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S0022-3476(95)70514-7","article-title":"Reference ranges for newer thyroid function tests in premature infants.","volume":"126","author":"Adams","year":"1995","journal-title":"J Pediatr"},{"key":"2021121003434907500_B2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0140-6736(88)91001-X","article-title":"TSH-receptor antibodies in mothers with Graves' disease and outcome in their offspring.","volume":"1","author":"Matsuura","year":"1988","journal-title":"Lancet"},{"key":"2021121003434907500_B3","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S0022-3476(95)70179-6","article-title":"Central hypothyroidism resulting from pituitary suppression and peripheral thyrotoxicosis in a premature infant born to a mother with Graves' disease.","volume":"127","author":"Hashimoto","year":"1995","journal-title":"J Pediatr"},{"key":"2021121003434907500_B4","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1203\/00006450-199708000-00014","article-title":"The mechanism of transient hypothyroxinemia in infants born to mothers with Graves' disease.","volume":"42","author":"Matsuura","year":"1997","journal-title":"Pediatr Res"},{"key":"2021121003434907500_B5","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1542\/peds.84.2.262","article-title":"Acute thyroxine ingestion in pediatric 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