Grave’s disease in Pregnancy

1. GRAVE’S DISEASE IN PREGNANCY
Divisi Endokrin Metabolik Diabetes

2. A woman who was 10 weeks pregnant presented with nausea,
vomiting, and palpitations for 2 weeks. She had a family history of
thyroid dysfunction, with her elder sister and mother having
undergone RAIA therapy for an overactive thyroid gland. On
examination, she was dehydrated with tachycardia and bilateral
tremors. She also had proptosis and a small palpable goitre with an
audible bruit.
TFT results:
free T4 40.5 pmol/L (11.5–22.7)
free T3 15.4 pmol/L (3.5–6.5)
TSH <0.01 mU/L (0.35–5.5)

3. Manakah dari pemeriksaan dibawah ini yang sangat berguna untuk tatalaksana pasien?
A. β-hCG levels
B. FNAC thyroid nodule
C. Thyroid ultrasound
D. Thyroid uptake scan
E. TSH receptor antibody

4. Answer
E. TSH receptor antibody

5. 2018 ETA Guideline for the Management of Graves’ Hyperthyroidism

6. Guidelines & recommendations on the use of Thyroid Receptor Antibodies (TRAb) during pregnancy
Lancet Diabetes Endocrinol 2013; 1: 238–49