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Thyroid
Successful Use of Iodine and Levothyroxine to Treat Graves' Disease in a Pregnant Patient with Allergy to Antithyroid Drugs and High Thyrotropin-Binding Inhibitor Immunoglobulin After Radioiodine Therapy

To cite this article:
Sumihisa Kubota, Hidemi Ohye, Ichiro Sasaki, Eijun Nishihara, Takumi Kudo, Shuji Fukata, Nobuyuki Amino, Kanji Kuma, Nobuaki Mitsuda, Akira Miyauchi. Thyroid. December 2005, 15(12): 1373-1376. doi:10.1089/thy.2005.15.1373.

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Sumihisa Kubota
Kuma Hospital, Kobe, Japan.
Hidemi Ohye
Kuma Hospital, Kobe, Japan.
Ichiro Sasaki
Kuma Hospital, Kobe, Japan.
Eijun Nishihara
Kuma Hospital, Kobe, Japan.
Takumi Kudo
Kuma Hospital, Kobe, Japan.
Shuji Fukata
Kuma Hospital, Kobe, Japan.
Nobuyuki Amino
Kuma Hospital, Kobe, Japan.
Kanji Kuma
Kuma Hospital, Kobe, Japan.
Nobuaki Mitsuda
Izumisano Municipal Hospital, Osaka, Japan.
Akira Miyauchi
Kuma Hospital, Kobe, Japan.

High titer of thyrotropin-binding inhibitor immunoglobulin (TBII) in patients with Graves' disease can cause fetal hyperthyroidism during pregnancy. Prevention of fetal hyperthyroidism by administration of antithyroid drug (ATD) and levothyroxine (LT4) to pregnant patients who previously received ablative therapy has been reported. We administered iodine and LT4 to a patient during gestation, because she had a severe adverse reaction to ATD. Although gestation proceeded normally, the infant showed transient neonatal hyperthyroidism right after birth. We believe that the fetus would have developed hyperthyroidsm if we had not administered iodine to the mother. Administration of iodine and LT4 to a pregnant patient with Graves' disease showing a high TBII after ablative therapy should be considered in rare patients with allergy to ATD.

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