Intrauterine foetal or neonatal hyperthyroidism can occur in cases in which a woman with previously treated Graves' disease has persisting stimulating antibodies to the thyroid-stimulating hormone (TSH) receptor (TSH-R). If stimulating [TSH-R(s)] and blocking [TSH- R(b)] antibodies are present in the maternal circulation, the onset of neonatal hyperthyroidism may be delayed, depending on the titre and affinity of the different antibodies that interact with the TSH-R.
Neonatal Graves' disease (Fig. 17.4) is transient and remits as the stimulating antibodies disappear from the circulation of the child.
