UMMS Affiliation

Department of Pediatrics

Date

10-1-1993

Document Type

Article

Subjects

Autoantibodies; Autoimmune Diseases; Binding, Competitive; Child; Congenital Hypothyroidism; Cross Reactions; Dose-Response Relationship, Drug; Humans; Hypothyroidism; Immunoglobulin G; Immunoglobulins, Thyroid-Stimulating; Infant, Newborn; Myxedema; Pilot Projects; Receptors, Thyrotropin; Thyroid Gland; Thyrotropin; Thyroxine

Disciplines

Endocrinology, Diabetes, and Metabolism | Life Sciences | Medicine and Health Sciences | Pediatrics

Abstract

Recent studies have suggested that maternal TSH receptor-blocking antibodies might be of primary etiological importance in some cases of transient congenital hypothyroidism (CH). Because these antibodies are extremely potent, we evaluated the feasibility of identifying babies at risk by using readily available newborn blood spots. Blood spots obtained from 84 normal babies (group 1) and from 354 infants whose initial T4 was less than the tenth percentile for the assay and whose TSH was 40 mU/L or more (group 2) were studied without knowledge of the diagnosis. Blood was eluted from spots overnight and evaluated for [125I]TSH binding inhibition (TBI) to solubilized porcine thyroid membranes. Four spots obtained from 3 group 2 babies, but none of those from the group 1 infants, exhibited TBI activity greater than 3 SD above the normal mean (33.9%). Four additional hypothyroxinemic infants whose mothers had Graves' disease were also negative. Subsequent follow-up revealed that all 3 positive babies had transient CH, and all 3 mothers had primary myxedema. Potent TBI activity was confirmed in the serum of all 3 mothers and in the 2 babies in whom it was evaluated at birth. We conclude that newborn blood spots can be used to detect potent maternal TBI activity, and that this identifies a baby likely to have transient, rather than permanent, CH. Because of their stability and ease of collection and handling, newborn blood spots should offer a convenient tool for future studies aimed at defining in more detail the incidence and clinical characteristics of this unique syndrome.

Rights and Permissions

Citation: J Clin Endocrinol Metab. 1993 Oct;77(4):1005-8. Link to article on publisher's website

DOI of Published Version

10.1210/jc.77.4.1005

Related Resources

Link to Article in PubMed

Journal Title

The Journal of clinical endocrinology and metabolism

PubMed ID

8104953

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