Neonataler Morbus Basedow bei Zwillingen einer Mutter mit schwerer T3-Hyperthyreose
| العنوان: | Neonataler Morbus Basedow bei Zwillingen einer Mutter mit schwerer T3-Hyperthyreose |
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| المؤلفون: | Annette Grüters, M. Lakomek, Heide Siggelkow, Michael Hüfner, C. Roth |
| المصدر: | DMW - Deutsche Medizinische Wochenschrift. 122:572-577 |
| بيانات النشر: | Georg Thieme Verlag KG, 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | endocrine system, Pediatrics, medicine.medical_specialty, endocrine system diseases, Dizygotic twin, 030209 endocrinology & metabolism, Trab, 03 medical and health sciences, 0302 clinical medicine, Thyroid peroxidase, medicine, Euthyroid, Pregnancy, Triiodothyronine, biology, business.industry, General Medicine, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Failure to thrive, biology.protein, Propylthiouracil, medicine.symptom, business, hormones, hormone substitutes, and hormone antagonists, medicine.drug |
| الوصف: | History and clinical findings Dizygotic twin sisters were born to a woman who, shortly before becoming pregnant, had developed Graves' disease with markedly elevated triiodothyronine (T3) levels and highly positive TSH receptor antibody titres (TRAb: 169 mU/ml). From the second week of life onwards they had a goitre and hyperexcitability, tachycardia and failure to thrive were noted. In addition, twin I had mild exophthalmos. As thyrostatic treatment of the mother was very difficult, intrauterine hypothyroidism or transitory hyperthyroidism had presumably occurred in the twins. Investigations Twin I had maximal thyroxine (T4) concentration of 26.2 micrograms/dl, while it was 24.7 micrograms/dl in twin II with suppressed TSH. Both twins had high concentrations of TRAb and antibodies against thyroid peroxidase. Diagnosis, treatment and course With the diagnosis of neonatal Graves' disease established, both twins were treated with propranolol (2 mg/kg.d) and phenobarbitone (2-4 mg/kg.d). Twin I, whose symptoms were more severe, also received propylthiouracil (5 mg/kg.d) until euthyroidism had been achieved. Although twin II became euthyroid spontaneously, she gained weight only slowly and microcephaly developed together with definite motor and mental retardation. It remains unclear whether these were consequences of intrauterine hypothyroidism or post-partum hyperthyroidism. Conclusion Graves' disease during pregnancy demands interdisciplinary collaboration between gynaecologist, physician and paediatrician to prevent severe sequelae in the children. Early risk assessment is possible by measuring the TSH receptor antibody titre in umbilical blood. |
| تدمد: | 1439-4413 0012-0472 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::3906bb5c4c0c2809703db59afd25fb7cTest https://doi.org/10.1055/s-2008-1047656Test |
| رقم الانضمام: | edsair.doi...........3906bb5c4c0c2809703db59afd25fb7c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14394413 00120472 |
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