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.