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Am J Perinatol 2003; 20(2): 059-062
DOI: 10.1055/s-2003-38320
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Gastrointestinal Malformations in Two Infants Born to Women with Hyperthyroidism Untreated in the First Trimester

Muhieddine Seoud1 , Anwar Nassar1 , Ihab Usta1 , Mohammad Mansour1 , Ibrahim Salti2 , Khaled Younes3
  • 1Obstetrics and Gynecology, The American University of Beirut Medical Center, New York, New York
  • 2Internal Medicine, The American University of Beirut Medical Center, New York, New York
  • 3Pediatrics, The American University of Beirut Medical Center, New York, New York
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Publication History

Publication Date:
27 March 2003 (online)

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ABSTRACT

We report two infants with gastrointestinal anomalies: one with esophageal atresia and tracheo-esophageal fistula and the other with biliary tree atresia, born to hyperthyroid women diagnosed and treated with methimazole after 14 weeks' gestation. Euthyroidism was documented in both infants. These cases raise the issue of whether untreated hyperthyroidism and not methimazole intake is the teratogen.

KEYWORDS

Hyperthyroidism - methimazole - gastrointestinal anomalies

REFERENCES

  • 1 Ecker J L, Musci T J. Treatment of thyroid disease in pregnancy.  Obstet Gynecol Clin North Am . 1997;  24 575-589
    CrossrefPubMedSearch in Google Scholar
  • 2 Jaffe R B. Endocrine-metabolic alterations induced in pregnancy. In: Yen SS, Jaffe RB, eds. Reproductive Endocrinology: Physiology, Pathophysiology and Clinical Management 2nd ed. Philadelphia: WB Saunders 1986: 735-788
    Search in Google Scholar
  • 3 Momotani N, Ito K, Hamada N, Ban Y, Nishikawa Y, Mimura T. Maternal hyperthyroidism and congenital malformation in the offspring.  Clin Endocrinol . 1984;  20 695-700
    CrossrefPubMedSearch in Google Scholar
  • 4 Wing D A, Millar L K, Koonings P P, Montoro M N, Mestman J H. A comparison of propylthiouracil versus methimazole in the treatment of hyperthyroidism in pregnancy.  Am J Obstet Gynecol . 1994;  170 90-95
    PubMedSearch in Google Scholar
  • 5 Clementi M, Di Gianantonio E, Pelo E, Mammi I, Basile R T, Tenconi R. Methimazole embryopathy: delineation of the phenotype.  Am J Med Genet . 1999;  83 43-46
    CrossrefPubMedSearch in Google Scholar
  • 6 Mujitaba Q, Burrow G N. Treatment of hyperthyroidism in pregnancy with propylthiouracil and methimazole.  Obstet Gynecol . 1975;  46 282-286
    PubMedSearch in Google Scholar
  • 7 Yeo C P, Khoo D H, Eng P H, Tank H K, Yo S L, Jacob E. Prevalence of gestational thyrotoxicosis in Asian women evaluated in the 8th to 14th weeks of pregnancy: correlations with total and free beta human chorionic gonadotrophin.  Clin Endocrinol . 2001;  55 391-398
    CrossrefPubMedSearch in Google Scholar
  • 8 Lee Y S, Poh L, Loke K Y. An activating mutation of the thyrotropin receptor gene in hereditary non-autoimmune hyperthyroidism.  J Pediatr Endorinol Metab . 2002;  15 211-215
    PubMedSearch in Google Scholar
  • 9 Fuhrer D, Warner J, Sequeira M, Paschke R, Gregory J, Ludgate M. Novel TSHR germline mutation (Met 463Val) masquerading as Graves' disease in a large Welsh kindred with hyperthyroidism.  Thyroid . 2000;  10 1035-1041
    CrossrefPubMedSearch in Google Scholar
  • 10 Martinez-Frias M L, Cereijo A, Rodriguez-Pinilla E, Urioste M. Methimazole in animal feed and congenital aplasia cutis.  Lancet . 1992;  339 742-743
    PubMedSearch in Google Scholar
  • 11 Wilson L C, Kerr B A, Wilkinson R, Fossard C, Donnai D. Choanal atresia and hypothelia following methimazole exposure in utero: a second report.  Am J Med Genet . 1998;  75 220-222
    CrossrefPubMedSearch in Google Scholar
  • 12 Sugrue D, Drury M I. Hyperthyroidism complicating pregnancy: results of treatment by antithyroid drugs in 77 pregnancies.  Br J Obstet Gynaecol . 1980;  87 970-975
    PubMedSearch in Google Scholar
  • 13 Vogt T, Stolz W, Landthaler M. Aplasia cutis congenita after exposure to methimazole: a causal relationship?.  Br J Dermatol . 1995;  133 994-996
    PubMedSearch in Google Scholar
  • 14 Ramirez A, Espinosa de los Monteros A, Parra A, De Leon B. Esophageal atresias and tracheoesophageal fistula in two infants born to hyperthyroid women receiving methimazole (Tapazol) during pregnancy.  Am J Med Genet . 1992;  44 200-202
    CrossrefPubMedSearch in Google Scholar
  • 15 Johnsson E, Larsson G, Lijunggren M. Severe malformations in infant born to hyperthyroid woman on methimazole [letter].  Lancet . 1997;  350 1520
    PubMedSearch in Google Scholar
  • 16 Piccoli D A, Spinner N B. Alagille syndrome and the Jagged1 gene.  Semin Liver Dis . 2001;  21 525-534
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Briggs G G. Methimazole. In: Briggs GG, Freeman RK, Yaffe SJ, eds. Drugs in Pregnancy and Lactation 4th ed. Baltimore: Williams and Wilkins 1994: 562-564
    Search in Google Scholar