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September 1992, Vol 146, No. 9 >
Article | September 1992

The Role of Maternal Autoimmune Thyroid Disease in Neonatal Hypothyroidism FREE

ALLEN W. ROOT, MD
Am J Dis Child. 1992;146(9):1029-1030. doi:10.1001/archpedi.1992.02160210031015.
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Blizzard et al1 were among the first to suggest that maternal autoimmune thyroid disease (AITD) may be of pathogenic significance in the development of neonatal hypothyroidism. Matsuura et al2 first described the occurrence of transient neonatal hypothyroidism due to the transplacental passage of maternal immunoglobulins that inhibited the binding of thyrotropin to its receptor on the thyrotrope membrane. Since then, the role of AITD in the pathogenesis of both transient and permanent forms of this disorder has been subjected to renewed investigation. Many antibodies of diverse biological activity have been found in the serum samples of women with known or subclinical AITD who have delivered infants with neonatal hypothyroidism. These include IgGs that: (1) inhibit binding of thyrotropin to its receptor (TBIIg, measured in a radioreceptor assay), (2) inhibit thyrotropin-mediated growth of thyroid cells (TGIIg, assessed by the effect of serum immunoglobulins on thyrotropin-induced increase in nuclear DNA

REFERENCES

1 +
Blizzard RM, Chandler RW, Landing BH, Pettit MD, West CD.  Maternal autoimmunization to thyroid as a probable cause of athyreotic cretinism . N Engl J Med . 1960;;263:327-336.
2 +
Matsuura N, Yamada Y, Nohara Y, et al.  Familial neonatal transient hypothyroidism due to maternal TSH-binding inhibitor immunoglobulins . N Engl J Med . 1980;;303:738-741.
3 +
Brown RS, Keating P, Mitchell E.  Maternal thyroid-blocking immunoglobulins in congenital hypothyroidism . J Clin Endocrinol Metab . 1990;; 70:1341-1346.
4 +
Chiovato L, Vitti P, Marcocci C, et al.  TSH-blocking antibodies and congenital hypothyroidism . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:141-148.
5 +
Dussault JH.  Thyroid growth blocking antibodies and congenital hypothyroidism . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:135-140.
6 +
Zakarija M, McKenzie JM, Eidson MS.  Transient neonatal hypothyroidism: characterization of maternal antibodies to the thyrotropin receptor . J Clin Endocrinol Metab . 1990;;70:1239-1246.
7 +
Bogner U, Gruters A, Sigle B, Helge H, Schleusnener H.  Cytotoxic antibodies in congenital hypothyroidism . J Clin Endocrinol Metab . 1989;;68:671-675.
8 +
Boyages SC, Lens JW, van der Gaag RD, Maberly GF, Eastman CJ, Drexhage HA.  Sporadic and endemic congenital hypothyroidism: evidence for autosensitization . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;: 123-132.
9 +
Toublanc JE, Gruters A, Bogner U, Fulla Y, Dugue MA.  Study of antibody-dependent cell mediated cytotoxicity and thyroid growth blocking antibodies in congenital hypothyroidism . Arch Fr Pediatr . 1991;;48:89-94.
10 +
Fort P, Lifshitz F, Pugliese M, Klein M.  Neonatal thyroid disease: differential expression in three successive offspring . J Clin Endocrinol Metab . 1988;;66:645-647.
11 +
Zakarija M, McKenzie JM, Hoffman WH.  Prediction and therapy of intrauterine and late-onset neonatal hyperthyroidism . J Clin Endocrinol Metab . 1986;;62:368-371.
12 +
Fisher DA.  Neonatal thyroid disease in the offspring of women with autoimmune thyroid disease . Thyroid Today . 1986;;11:1-7.
13 +
Matsuura N, Konishi J, Fujieda K, et al.  Transient hypothyroidism due to maternal TSH-receptor blocking antibodies: character of their IgG and long-term prognosis of their infants . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:111-120.
14 +
Delange F, Dodion J, Wolter R, et al.  Transient hypothyroidism in the newborn infant . J Pediatr . 1978;;92:974-976.
15 +
Braverman L.  Autoimmunity . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:151-154.
16 +
Usala AL, Wexler I, Posch A, Gupta MK.  Elimination kinetics of maternally derived TSH receptor blocking antibodies in a newborn with significant TSH elevation . AJDC . 1992;;146: 1030-1031.
17 +
Mandel SJ, Larsen PR, Seely EW, Brent GA.  Increased need for thyroxine during pregnancy in women with primary hypothyroidism . N Engl J Med . 1990;;323:91-96.
18 +
Vulsma T, Gons MH, de Vijlder JJM.  Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis . N Engl J Med . 1989;;321:13-16.
19 +
Matsuura N, Konishi J.  Transient hypothyroidism in infants born to mothers with chronic thyroiditis: a nationwide study of twenty-three cases . EndocrinolJpn . 1990;;37:369-379.
20 +
Matsuura N, Konishi J, Harada S, et al.  The prediction of thyroid function in infants born to mothers with chronic thyroiditis . Endocrinol Jpn . 1989;;36:865-871.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Blizzard RM, Chandler RW, Landing BH, Pettit MD, West CD.  Maternal autoimmunization to thyroid as a probable cause of athyreotic cretinism . N Engl J Med . 1960;;263:327-336.
2 +
Matsuura N, Yamada Y, Nohara Y, et al.  Familial neonatal transient hypothyroidism due to maternal TSH-binding inhibitor immunoglobulins . N Engl J Med . 1980;;303:738-741.
3 +
Brown RS, Keating P, Mitchell E.  Maternal thyroid-blocking immunoglobulins in congenital hypothyroidism . J Clin Endocrinol Metab . 1990;; 70:1341-1346.
4 +
Chiovato L, Vitti P, Marcocci C, et al.  TSH-blocking antibodies and congenital hypothyroidism . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:141-148.
5 +
Dussault JH.  Thyroid growth blocking antibodies and congenital hypothyroidism . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:135-140.
6 +
Zakarija M, McKenzie JM, Eidson MS.  Transient neonatal hypothyroidism: characterization of maternal antibodies to the thyrotropin receptor . J Clin Endocrinol Metab . 1990;;70:1239-1246.
7 +
Bogner U, Gruters A, Sigle B, Helge H, Schleusnener H.  Cytotoxic antibodies in congenital hypothyroidism . J Clin Endocrinol Metab . 1989;;68:671-675.
8 +
Boyages SC, Lens JW, van der Gaag RD, Maberly GF, Eastman CJ, Drexhage HA.  Sporadic and endemic congenital hypothyroidism: evidence for autosensitization . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;: 123-132.
9 +
Toublanc JE, Gruters A, Bogner U, Fulla Y, Dugue MA.  Study of antibody-dependent cell mediated cytotoxicity and thyroid growth blocking antibodies in congenital hypothyroidism . Arch Fr Pediatr . 1991;;48:89-94.
10 +
Fort P, Lifshitz F, Pugliese M, Klein M.  Neonatal thyroid disease: differential expression in three successive offspring . J Clin Endocrinol Metab . 1988;;66:645-647.
11 +
Zakarija M, McKenzie JM, Hoffman WH.  Prediction and therapy of intrauterine and late-onset neonatal hyperthyroidism . J Clin Endocrinol Metab . 1986;;62:368-371.
12 +
Fisher DA.  Neonatal thyroid disease in the offspring of women with autoimmune thyroid disease . Thyroid Today . 1986;;11:1-7.
13 +
Matsuura N, Konishi J, Fujieda K, et al.  Transient hypothyroidism due to maternal TSH-receptor blocking antibodies: character of their IgG and long-term prognosis of their infants . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:111-120.
14 +
Delange F, Dodion J, Wolter R, et al.  Transient hypothyroidism in the newborn infant . J Pediatr . 1978;;92:974-976.
15 +
Braverman L.  Autoimmunity . In: Delange F, Fisher DA, Glinoer D, eds. Research in Congenital Hypothyroidism . New York, NY: Plenum Press; 1989;:151-154.
16 +
Usala AL, Wexler I, Posch A, Gupta MK.  Elimination kinetics of maternally derived TSH receptor blocking antibodies in a newborn with significant TSH elevation . AJDC . 1992;;146: 1030-1031.
17 +
Mandel SJ, Larsen PR, Seely EW, Brent GA.  Increased need for thyroxine during pregnancy in women with primary hypothyroidism . N Engl J Med . 1990;;323:91-96.
18 +
Vulsma T, Gons MH, de Vijlder JJM.  Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis . N Engl J Med . 1989;;321:13-16.
19 +
Matsuura N, Konishi J.  Transient hypothyroidism in infants born to mothers with chronic thyroiditis: a nationwide study of twenty-three cases . EndocrinolJpn . 1990;;37:369-379.
20 +
Matsuura N, Konishi J, Harada S, et al.  The prediction of thyroid function in infants born to mothers with chronic thyroiditis . Endocrinol Jpn . 1989;;36:865-871.

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