Thyroid Hemiagenesis with Postpartum Silent Thyroiditis

Abstract

A 28-year-old woman with thyroid hemiagenesis, who had been diagnosed as having Graves' disease, became pregnant during the course of methimazole treatment. The treatment was terminated in the second trimester. She delivered a normal infant at full term. She became thyrotoxic 3 months after the delivery, hypothyroid 6 months after the delivery, and finally euthyroid 11 months after the delivery without undergoing any treatment. This clinical course indicates that she developed silent thyroiditis after the delivery. A diagnosis of thyroid hemiagenesis was made on the basis of ultrasonography of the thyroid and 99m Tc-pertechnetate thyroid scintiscan.

Clinical and epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population

“…Most observed cases of thyroid hemiagenesis have been found only incidentally after patients have been examined for thyroid conditions since the absence of one thyroid lobe usually does not cause clinical symptoms by itself [2][3][4][5][6][7][8][9]. There has been only one survey to establish its prevalence among patients with thyroid disorders [2].…”

“…There has been only one survey to establish its prevalence among patients with thyroid disorders [2]. Since thyroid hemiagenesis is very rare entity, many case reports have been published describing the association with other thyroid diseases or congenital defects, mostly cardiac [2][3][4][5][6][7][8][9]. The associated diseases in the intact thyroid lobe include benign adenoma, multinodular goiter, hyperthyroidism, chronic thyroiditis, Graves' disease, and rarely carcinoma.…”

“…Since thyroid hemiagenesis is a rare entity, many case reports have been published describing the association with other thyroid diseases or congenital defects [2][3][4][5][6][7][8][9]. The increased prevalence of thyroid diseases in association with thyroid hemiagenesis and observed female preponderance have been questioned after surveys, investigating the true prevalence of thyroid hemiagenesis in normal population [10][11][12].…”

Autoimmune Abnormalities of Postpartum Thyroid Diseases

“…Shortly prior to becoming pregnant, an increase in thyroperoxidase autoantibodies (TPOAb) was observed in this woman. In another Japanese woman with thyroid hemiagenesis, GD was present in the pregnancy that preceded the postpartum period during which PPT appeared (45). Other case reports of PPT following GD have appeared in the literature (46, 47), one being noteworthy because of the sequence onset of GD → PPT → relapse of GD (47).…”

Increased risk of thyroid pathology in patients with thyroid hemiagenesis: results of a large cohort case–control study

“…However, the etiopathogenesis of this condition, its clinical significance, impact on thyroid function, and development of associated thyroid pathologies as well as the management of patients in whom the anomaly is diagnosed are still a matter of debate (1,(4)(5)(6)(7). To date, individual case studies have been reported most often, mainly as an anatomical curiosity or as a diagnostic dilemma, whereas the literature lacks methodological studies of large groups of patients presenting THA, which would provide objective answers to these controversies (4,5,(8)(9)(10)(11)(12)(13). Since hormone production by a single thyroid lobe is sufficient to maintain clinical euthyroidism, provided no concomitant thyroid pathology exists, THA has been up to now regarded as a rather benign developmental variant requiring no treatment.…”