Three siblings with self-resolving congenital hyperthyrotropinaemia secondary to thyrotropin receptor blocking antibodies

Authors

  • Peter Azzopardi,

    Corresponding author
    1. Paediatric Registrar, Royal Children's Hospital, Melbourne, Victoria, Australia,
      Dr. Peter Azzopardi, Royal Children's Hospital, Flemington Road Parkville 3052, Victoria, Australia. email: peter.azzopardi@rch.org.au
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  • Mike Forrester,

    1. Consultant Paediatrician, Department of Paediatrics, Barwon Health, Geelong, Victoria, Australia and
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  • Sarah Ehtisham

    1. Endocrinologist, Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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Dr. Peter Azzopardi, Royal Children's Hospital, Flemington Road Parkville 3052, Victoria, Australia. email: peter.azzopardi@rch.org.au

Abstract

Thyrotropin receptor blocking antibodies are a rare cause of hyperthyrotropinaemia and more rarely of congenital hypothyroidism. We report a case of hyperthyrotropinaemia but normal thyroid hormone in the newborn of a mother with hypothyroidism treated with thyroxine. Two older siblings had similar high thyrotropin and normal thyroid function in the newborn period which did not require hormone treatment and resolved spontaneously. Demonstration of thyrotropin receptor antibodies in the child confirmed our diagnosis. Our case was not treated with thyroid replacement hormone and has remained biochemically euthyroid, with thyrotropin levels returning to normal over a period of months.

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