open access

Vol 65, No 1 (2014)
Case report
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19
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Increased size and vascularisation, plus decreased echogenicity, of foetal thyroid in two-dimensional ultrasonography caused by maternal Graves’ disease

Małgorzata Gietka-Czernel, Marzena Dębska, Piotr Kretowicz, Helena Jastrzębska, Wojciech Zgliczyński
DOI: 10.5603/EP.2014.0009
·
Endokrynologia Polska 2014;65(1):64-68.

open access

Vol 65, No 1 (2014)
Case report
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19

Abstract

Foetal ultrasonography monitoring is a valuable tool in assessing foetal thyroid function when pregnancy is complicated by maternal Graves’ disease with accompanying high levels of TSH receptor antibodies, or when antithyroid drug therapy is instituted. Among several ultrasonographic signs of foetal thyroid disorder such as abnormalities in bone maturation and heart rhythm, cardiac failure, hydrops, intrauterine growth restriction and polyhydramnios, goitre is the most sensitive one. Here we report three cases of pregnant women with Graves’ disease accompanied by very high serum levels of TSH receptor antibodies. In all three cases, as documented by foetal or neonatal serum TSH and thyroid hormones measurements, foetal thyroid dysfunction occurred. The only ultrasonographic sign of foetal involvement was a goitre with decreased echogenicity and increased vascularisation, central or peripheral. This is the first report demonstrating that a foetal thyroid gland when affected by transplacental passage of maternal TSH receptor stimulating antibodies can present exactly the same characteristic ultrasound pattern of Graves’ disease as in adults. (Endokrynol Pol 2014; 65 (1): 64–68)

Abstract

Foetal ultrasonography monitoring is a valuable tool in assessing foetal thyroid function when pregnancy is complicated by maternal Graves’ disease with accompanying high levels of TSH receptor antibodies, or when antithyroid drug therapy is instituted. Among several ultrasonographic signs of foetal thyroid disorder such as abnormalities in bone maturation and heart rhythm, cardiac failure, hydrops, intrauterine growth restriction and polyhydramnios, goitre is the most sensitive one. Here we report three cases of pregnant women with Graves’ disease accompanied by very high serum levels of TSH receptor antibodies. In all three cases, as documented by foetal or neonatal serum TSH and thyroid hormones measurements, foetal thyroid dysfunction occurred. The only ultrasonographic sign of foetal involvement was a goitre with decreased echogenicity and increased vascularisation, central or peripheral. This is the first report demonstrating that a foetal thyroid gland when affected by transplacental passage of maternal TSH receptor stimulating antibodies can present exactly the same characteristic ultrasound pattern of Graves’ disease as in adults. (Endokrynol Pol 2014; 65 (1): 64–68)

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Keywords

foetal thyroid ultrasonography; maternal Graves’ disease

About this article
Title

Increased size and vascularisation, plus decreased echogenicity, of foetal thyroid in two-dimensional ultrasonography caused by maternal Graves’ disease

Journal

Endokrynologia Polska

Issue

Vol 65, No 1 (2014)

Pages

64-68

Published online

2014-02-19

DOI

10.5603/EP.2014.0009

Bibliographic record

Endokrynologia Polska 2014;65(1):64-68.

Keywords

foetal thyroid ultrasonography
maternal Graves’ disease

Authors

Małgorzata Gietka-Czernel
Marzena Dębska
Piotr Kretowicz
Helena Jastrzębska
Wojciech Zgliczyński

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