Review of antithyroid drug use during pregnancy and report of a case of aplasia cutis.
Review of antithyroid drug use during pregnancy and report of a case of aplasia cutis.
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妊娠期抗甲状腺药物使用回顾及皮肤发育不良一例报告。
DOI：
10.1089/thy.1994.4.129
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Larsen,PR
中科院分区：
文献类型：
--
作者：
Mandel,SJ;Brent,GA;Larsen,PR
硫胺治疗改善了妊娠合并产妇甲状腺功能亢进的结局，对认知和躯体发育无长期影响。然而，这些药物，特别是甲巯咪唑（MMI）是否与先天性皮肤发育不全（ACC）有关，以及如何在使用这些药物时最好地避免胎儿甲状腺功能的损害，这些问题仍然存在。我们报告一例ACC并回顾相关文献。我们的结论是，没有足够的证据来建立或消除ACC和MMI使用之间的直接因果关系。由于丙硫脲嘧啶是一种同样有效的抗甲状腺药物，并且与ACC无关，因此它是妊娠期间甲状腺功能亢进的首选硫胺。我们的综述还表明，使用足以维持母体血清游离甲状腺素浓度在高正常或轻度甲状腺毒性范围内的硫酰胺剂量，可以将新生儿甲状腺功能的损害降到最低。
Thioamide therapy has improved the outcome of pregnancies complicated by maternal hyperthyroidism, without long-term effects on cognitive and somatic development. However, there remain questions concerning whether these drugs, especially methimazole (MMI), may be associated with aplasia cutis congenita (ACC) and how best to avoid impairment of fetal thyroid function during their use. We report an example of ACC and review the relevant literature. We conclude that there is insufficient evidence either to establish or eliminate a direct causal relationship between ACC and MMI use. Since propylthiouracil is an equally effective antithyroid agent and has not been associated with ACC, it is the preferred thioamide for hyperthyroidism during pregnancy. Our review also indicates that impairment of neonatal thyroid function may be minimized by using a thioamide dose that is just sufficient to maintain the maternal serum free thyroxine concentration in the high normal or slightly thyrotoxic range.