Congenital thyrotoxicosis, hepatosplenomegaly and jaundice in two infants of exophthalmic mothers.

Maternal History Both infants were the offspring of mothers who had undergone thyroidectomy for Graves's disease, two years and four years respectively, before the birth of the affected infant. In both mothers the course of the thyrotoxicosis was unusual in that there was no weight loss during the course of the disease and the exophthalmos persisted unchanged after operation. We consider that both women had a supra-thyroid (pituitary) type of thyrotoxicosis, and that the anterior pituitary continued to be overactive after the operation. The mother of the first infant was treated pre-operatively with Lugol's iodine and phenobarbitone. The mother of the second infant received Lugol's iodine and thiouracil before her operation. Neither of these women was thyrotoxic during her pregnancy, though the exophthalmos was marked. Their ages were 21 and 25 respectively at the time of delivery. The mother of the first infant was thought, two months after delivery, to show some very minor signs of thyrotoxicosis. At that time her basal metabolic rate was + 31 %. There was a fine tremor and some tachycardia, but her exophthalmos was out of proportion to the toxic signs and she had lost no weight. The mother of the second infant was not thyrotoxic during or after her pregnancy, and gave birth to a normal living female infant 16 months later. There was no evidence of syphilis, toxoplasmosis or blood group incompatibility in either of the mothers or the infants. The 24-hour 17-ketosteroid excretion in the first mother was estimated two months after delivery, and was 8-65 mg. %. Infants' History