Format

Send to

Choose Destination
See comment in PubMed Commons below
Thyroid. 2014 Nov;24(11):1656-61. doi: 10.1089/thy.2013.0625. Epub 2014 Sep 11.

Conservative management of pregnancy in patients with resistance to thyroid hormone associated with Hashimoto's thyroiditis.

Author information

1
Department of Endocrinology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc , Brussels, Belgium .

Abstract

BACKGROUND:

Resistance to thyroid hormone (RTH) is a rare thyroid disorder characterized by elevated free thyroid hormones with non-suppressed thyrotropin (TSH). Guidelines for the management of pregnancy in patients with RTH are not well defined. Chorionic villus biopsy is sometimes proposed to manage treatment based on the genotype of the fetus.

PATIENT FINDINGS:

A woman with RTH (c1243C>T, pR320C mutation in the thyroid hormone receptor β (THRB gene)) associated with Hashimoto's thyroiditis (HT) had three successful pregnancies. During the pregnancies, the mother was treated with levothyroxine (LT4). She never underwent chorionic villus sampling. The babies had normal birth weights. The first child harbored the THRB mutation.

SUMMARY AND CONCLUSIONS:

The management of pregnancies in patients with RTH and the indication for chorionic villus sampling are discussed in these cases. In RTH patients, pregnancies must be planned and closely followed. There is no need for prenatal diagnosis of RTH if the patient, due to limited thyroidal reserve, cannot produce excess of thyroid hormones to harm a normal fetus. The more common challenge in RTH remains how to best manage high maternal thyroid hormone levels, and whether or not to lower thyroid hormone levels based on the genotype of the fetus.

PMID:
25099553
DOI:
10.1089/thy.2013.0625
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Mary Ann Liebert, Inc.
    Loading ...
    Support Center