Unusual congenital goiter due to maternal Hashimoto thyroiditis: a case report

TL;DR

A newborn developed a rare congenital goiter due to high levels of maternal thyroid antibodies from Hashimoto thyroiditis.

Contribution

This case report highlights a rare instance of congenital goiter caused by maternal Hashimoto thyroiditis and high TPOAb levels.

Findings

A male newborn presented with grade 3 goiter and hypothyroidism due to maternal Hashimoto thyroiditis.

Levothyroxine treatment normalized thyroid function in the newborn.

Neurological development remained normal following treatment.

Abstract

Congenital hypothyroidism (CH) is the most common cause of endocrinopathy in the newborn Its incidence lies between 1 in 3,000 and 1 in 2,000, However, congenital goiter is a rare form of presentation. Hypothyroidism secondary to autoimmune etiology is extremely rare, with an incidence of 1:84.700–1:31.000 newborns. Anti-thyroid peroxidase antibodies (TPOAb) are able to cross the placenta but rarely induce hypothyroidism in the newborn, much less goiter. A case of congenital goiter in a male newborn secondary to maternal high TPOAb levels is reported. The mother was diagnosed of Hashimoto thyroiditis prior to the pregnancy. At birth, a grade 3 goiter was detected in the newborn. Laboratory testings revealed hypothyroidism with free thyroxine of 7.6 pmol/L, thyroid-stimulating hormone of 108 mUI/L and high TPOAb levels. Treatment with Levothyroxine was started the second day of life with progressive thyroid function normalization. Neurological development has been normal until the date.

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