Postpartum Thyroid Disease

Amino, Nobuyuki

doi:10.1007/978-1-4684-5973-9_8

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Postpartum thyroid syndromes distinct from postpartum thyroiditis have also been identified and include postpartum disturbances in thyroid function in patients with previous or current thyroid disease (2,3,13) and postpartum secondary hypothyroidism (14,15). Combinations of these postpartum thyroid syndromes, as well as combinations of preexisting Graves' disease and Hashimoto's disease with postpartum thyroiditis, have also been described (16 -19).…”

Section: Introductionmentioning

confidence: 95%

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Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

2001

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Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of the thyroid. The prevalence ranges from 5-7%. We discuss the role of antibodies (especially thyroid peroxidase antibodies), complement, activated T cells, and apoptosis in the outbreak of postpartum thyroiditis. Postpartum thyroiditis is conceptualized as an acute phase of autoimmune thyroid destruction in the context of an existing and ongoing process of thyroid autosensitization. From pregnancy an enhanced state of immune tolerance ensues. A rebound reaction to this pregnancy-associated immune suppression after delivery explains the aggravation of autoimmune syndromes in the puerperal period, e.g., the occurrence of clinically overt postpartum thyroiditis. Low thyroid reserve due to autoimmune thyroiditis is increasingly recognized as a serious health problem. 1) Thyroid autoimmunity increases the probability of spontaneous fetal loss. 2) Thyroid failure due to autoimmune thyroiditis-often mild and subclinical-can lead to permanent and significant impairment in neuropsychological performance of the offspring. 3) Evidence is emerging that as women age subclinical hypothyroidism-as a sequel of postpartum thyroiditis-predisposes them to cardiovascular disease. Hence, postpartum thyroiditis is no longer considered a mild and transient disorder. Screening is considered.

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Section: Introductionmentioning

confidence: 95%

“…Classically, a thyrotoxic phase is followed by a hypothyroid phase (1). Several intrinsic and environmental factors have been reported to play a pathophysiological role in its development (2)(3)(4)(5)(6). "Postpartum" thyroiditis may also occur after loss of pregnancy at 5-20 wk gestation (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

2001

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“…The risk of recurrence in subsequent pregnancies is about 25%. Long-term follow-up of these women is important because permanent hypothyroidism is an important sequel, particularly in women with high titers of microsomal antibody (20,21). TREATMENT Since the signs and symptoms of postpartum thyroiditis are usually mild and transient, specific therapy is usually not indicated (18).…”

Section: Coursementioning

confidence: 99%

Thyroid Dysfunction in the Recently Pregnant: Postpartum Thyroiditis

Burrow¹

1994

Thyroid

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“…Desta forma as doenças auto-imunes da tireóide tendem a reduzir sua expressão no período de gestação, exacerbando-se no período pós-parto (8,14,15). Assim, descreve-se a TPP como uma doença tiroidiana auto-imune, que acomete as mulheres no período pós-parto, onde há uma maior atividade imunológi-ca (6,10,17,23), onde ocorre hipo e/ou hipertiroidismo que pode evoluir para cura espontânea, hipotiroidismo permenente ou recorrência em gestações posteriores.…”

Section: Discussionunclassified

Tiroidite pós-parto: prevalência e evolução clínica

Barros

1998

Arq Bras Endocrinol Metab

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Recebido em 26/06/98Revisado em 18/11/98 Aceito em 25/11/98 RESUMO A tiroidite pós-parto (TPP) é uma disfunção tiroidiana, ainda pouco conhecida, que acomete mulheres no 1 o ano pós-parto. Estudos em nosso meio são escassos. Estudamos um grupo de 115 gestantes entre a 16 a e 20 a semana de gestação, quanto a disfunção tiroidiana (T3, T4, T4L e TSH) e presença de anticorpos antitiroidianos (anti-tireoglobulina e antiperoxidase tiroidiana Unitermos: Tiroidite Pós-parto; Doenças tiroidianas; Autoimunidade ABSTRACT Postpartum thyroiditis (PPT) is an autoimmune thyroid dysfunction that occurs in the first year after delivery. We evaluated the prevalence and clinical evolution of PPT in 115 pregnant women between the 16 th and 20 th weeks of gestation. We studied both thyroid function (T3, T4, T4L, TSH) and the presence of antithyroid antibodies (antithyroglobulin and antiperoxidase). Reevaluation was done six months postpartum. In the first phase, 12 (10.4%) were TPO-Ab positive: two (16.6%) had a miscarriage between the 5 th and 6 th month, three (25%) were euthyroid, three (25%) subclinic hypothyroidism and four (33,3%) PPT. The most frequent symptom was fatigue (4/4). All women showed risk factors for PPT. Based on our data, we recommend that pregnant women with risk factor for PPT should be screened during pregnancy and the postpartum period for the development of thyroid dysfunction. (Arq Bras Endocrinol Metab 1998;42/6:451-455) Keywords: Postpartum Thyroiditis; Thyroid diseases; Autoimmunity A TPP É UMA DISFUNÇÃO TIROIDIANA auto-imune, que acomete aproxinadamente 5,5% a 11,3% das mulheres entre o 3° e o 6° mês pós-parto (1), podendo ocorrer durante todo o 1 o ano pós-parto (2-6). Classicamente cursa com três fases: a primeira de tireotoxicose associada a hipocaptação de 131 I, seguida de hipotiroidismo e posterior recuperação do eutiroidismo (6-11). Embora a recuperação seja o usual, hipotiroidismo permanente e encontrado em algumas pacientes (1,3,7,10,12,13). O diag-

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Postpartum Thyroid Disease

Cited by 10 publications

References 13 publications

Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

Thyroid Dysfunction in the Recently Pregnant: Postpartum Thyroiditis

Tiroidite pós-parto: prevalência e evolução clínica

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