Follow-up of infants with hyperthyroidism

Right Decisions
SPEG (Scottish Paediatric Endocrine Group)
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Management of infants born to mothers with Graves’ Disease and at risk of thyrotoxicosis
Follow-up of infants with hyperthyroidism

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Neonatal hyperthyroidism due to maternal Graves’ disease is self-limiting, with duration determined by the rate of disappearance of maternal TRAb from infant circulation. TRAb half-life is reported to be approximately 12 days.

Monitoring

Weekly to biweekly review and thyroid function tests depending on clinical condition of the infant.
Taper treatment once asymptomatic and fT4 and TSH is within the reference range.

Prognosis

Average treatment duration is 1-2 months.
Hyperthyroidism generally resolves within 6 months but can continue for up to 12 months.
Once thyroid function has normalised off treatment, no further review is required.
There is a risk of recurrence in siblings in future pregnancies.