Download PDFPDF
Central congenital hypothyroidism caused by maternal thyrotoxicosis
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Importance of long term thyroid function monitoring in central congenital hypothyroidism secondary to maternal thyrotoxicosis
    • Lit Kim Chin, Paediatrician The Royal Children's Hospital
    • Other Contributors:
      • Mary White, Paediatric Endocrinologist
      • Peter Simm, Paediatric Endocrinologist

    We wish to share our clinical experience and support the importance of long term monitoring of thyroid function in patients with central congenital hypothyroidism caused by maternal thyrotoxicosis. This is a case series of three infants with prolonged hypothyroxinaemia unrelated to the initial management of neonatal Graves’ disease (NGD). In contrast to the minimal antenatal care reported in the case report. mothers of all infants in our case series had antenatal diagnosis of Graves’ disease with appropriate management and close follow up for signs of fetal hyperthyroidism. All infants were diagnosed with NGD within two weeks of birth with two infants being commenced on antithyroid medication for 2-4 weeks as they were symptomatic with NGD.

    With resolution of NGD, thyroid function tests were monitored with subsequent hypothyroxinaemia noted between 4-8 weeks of age. Having confirmed persistent hypothyroxinaemia, all infants were commenced on thyroxine (4-10mcg/kg/day) with regular follow up of their thyroid function tests.

    The development of hypothyroxinaemia after initial treatment of NGD is uncommon however has been described previously (1). In most cases, NGD remits by 3-12 weeks once maternal antibodies are cleared (2, 3). Early transient hypothyroxinaemia in infants of poorly controlled maternal Graves’ is well reported due to high circulating antibodies particularly in the third trimester (1, 4). Postulated mechanisms include suppression of the pituita...

    Show More
    Conflict of Interest:
    None declared.