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The Journal of Clinical Endocrinology... Jul 1994
Topics: Diabetes Mellitus, Type 1; Female; Humans; Postpartum Period; Pregnancy; Pregnancy in Diabetics; Thyroiditis, Autoimmune
PubMed: 8027256
DOI: 10.1210/jcem.79.1.8027256 -
Frontiers in Endocrinology 2015During pregnancy, the thyroid gland must produce 50% more thyroid hormone to maintain the euthyroid state. Women with decreased thyroid reserve preconception, most... (Review)
Review
During pregnancy, the thyroid gland must produce 50% more thyroid hormone to maintain the euthyroid state. Women with decreased thyroid reserve preconception, most typically due to Hashimoto's thyroiditis, may develop hypothyroidism during pregnancy. Data over the last 20 years have reported a strong association between subclinical hypothyroidism and adverse maternal/fetal events. As a result of this association, an increasing number of women are being screened for thyroid disease either preconception or at the first prenatal visit. Consequently, an ever increasing number of women are being initiated on levothyroxine for the first time during pregnancy. At present, there are very limited guidelines related to the management of the thyroid disease in these women postpartum. Based on an understanding of the physiology of the thyroid gland during pregnancy and postpartum, and the personal clinical experience of the author, recommendations for the postpartum management of women who were started on levothyroxine during pregnancy are presented.
PubMed: 26648909
DOI: 10.3389/fendo.2015.00183 -
Deutsche Medizinische Wochenschrift... Feb 2008
Review
Topics: Adult; Female; Hashimoto Disease; Humans; Postpartum Thyroiditis; Thyroiditis; Thyroiditis, Subacute; Thyroiditis, Suppurative
PubMed: 18253921
DOI: 10.1055/s-2008-1046710 -
Journal de Gynecologie, Obstetrique Et... May 2008Postpartum endocrine syndromes occur in the year after delivery. They are due to immunologic and vascular modifications during pregnancy. The Sheehan syndrome is the... (Review)
Review
Postpartum endocrine syndromes occur in the year after delivery. They are due to immunologic and vascular modifications during pregnancy. The Sheehan syndrome is the first described postpartum endocrine syndrome and consists on a hypophyse necrosis in relation with a hypovolemic shock during delivery. The immunologic consequences of the pregnancy are the most frequent, sometimes discrete and transitory. The physiological evolution of the endocrine glands during pregnancy and the most frequent post-partum endocrine syndromes are discussed: postpartum lymphocytic hypophysitis, thyroiditis and Sheehan' syndrome.
Topics: Endocrine Glands; Endocrine System Diseases; Female; Humans; Pregnancy; Puerperal Disorders; Syndrome
PubMed: 18314279
DOI: 10.1016/j.jgyn.2008.01.004 -
Polski Merkuriusz Lekarski : Organ... Jun 2006Postpartum thyroiditis is one of the most common endocrinological disorders annually affecting millions of women world-wide. It is is defined as a syndrome of transient... (Review)
Review
Postpartum thyroiditis is one of the most common endocrinological disorders annually affecting millions of women world-wide. It is is defined as a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery. A thyrotoxic phase of postpartum thyroiditis may be brief and unnoticed before a more long-lasting (permanent in up to 30%) hypothyroid phase occurs. The disease, found in approximately 5-10% of mothers in the general population, is an autoimmune disorder, and thyroid antibody-positive women in the first trimester have a 33% to 50% chance of developing thyroiditis in the postpartum period. Women suffering from other autoimmune conditions, or having a previous or family history of thyroid disease are at increased risk of its development. In this paper we present an overview of the pathogenesis, clinical aspects, diagnosis, and treatment options for postpartum thyroiditis with putting special emphasis on the results of recently published studies.
Topics: Diagnosis, Differential; Female; Humans; Postpartum Thyroiditis; Pregnancy; Thyroxine
PubMed: 17007279
DOI: No ID Found -
The Journal of the Association of... Jun 2002
Topics: Adult; Diagnosis, Differential; Female; Humans; Hypopituitarism; Postpartum Period; Thyroiditis
PubMed: 12240872
DOI: No ID Found -
Frontiers in Immunology 2022Human gestation leads to a number of physiological alterations which peak at the development of placentta known for, among many other functions, being a transient but... (Review)
Review
Human gestation leads to a number of physiological alterations which peak at the development of placentta known for, among many other functions, being a transient but highly potent endocrine organ. Hormonal activity of placenta is marked by its ability to continuously produce and secrete high levels of progesterone. Progesterone guards the well-being of the fetoplacental unit throughout the gestation and one of the proposed mechanisms of this principle involves the development of local and systemic immune tolerance mainly due to impediment of CD4+ lymphocyte activation. However, though these alterations are present and well-established, autoimmunity is not entirely rare and a wide spectrum of diseases can continue, or develop , throughout the gestation or even after the delivery. Up-to-date data supports the existence of a relationship between the clinical course of chosen autoimmune diseases and levels of circulating sex steroids. The most common autoimmune endocrinopathies in pregnant women are Hashimoto's disease, Graves' disease, and, more rarely, primary adrenal insufficiency in the form of Addison's disease. Gestation can influence the clinical course of these endocrinopathies in patients who were diagnosed before conception. Multiple particles, like TSH-receptor stimulating antibodies, thyroid hormones, glucocorticoids, and anti-thyroid medications, can cross the placental barrier and evoke biological action in fetal tissues. Thyroid pathology in the form of postpartum thyroiditis is particularly prevalent in patients with positive anti-thyroperoxidase and anti-thyroglobulin antibodies. Certain populations are more at risk of developing numerous gestational complications and require regular follow-up. In our paper, we would like to address physiological, physiopathological, and clinical aspects of endocrine autoimmunity throughout human gestation, as well as special circumstances to consider in pregnant women.
Topics: Autoimmune Diseases; Autoimmunity; Female; Graves Disease; Humans; Placenta; Pregnancy; Progesterone
PubMed: 35844617
DOI: 10.3389/fimmu.2022.907561 -
Acta Paediatrica (Oslo, Norway : 1992) Jun 2024
Topics: Humans; Female; Anxiety; Thyroiditis, Autoimmune; Postpartum Period
PubMed: 38536587
DOI: 10.1111/apa.17220 -
The Canadian Journal of Cardiology Jun 2019The etiology of peripartum cardiomyopathy (PPCM) remains unestablished, but the involvement of abnormal autoimmunity has been suggested. We report a case of PPCM that...
The etiology of peripartum cardiomyopathy (PPCM) remains unestablished, but the involvement of abnormal autoimmunity has been suggested. We report a case of PPCM that was triggered by postpartum thyroiditis. Despite the presence of myocardial damage indicated by cardiac magnetic resonance imaging, the patient's cardiac function completely recovered with the addition of bromocriptine to standard therapies. We discuss the role of thyroid hormones in the development of PPCM through aggravation of a prolactin-dependent antiangiogenic effect, and we argue that more attention should be paid to postpartum thyroiditis as a novel risk factor for PPCM.
Topics: Adult; Autoimmunity; Cardiomyopathies; Echocardiography; Electrocardiography; Female; Heart Failure; Humans; Magnetic Resonance Imaging, Cine; Peripartum Period; Postpartum Period; Pregnancy; Pregnancy Complications, Cardiovascular; Radiography, Thoracic; Thyroid Hormones; Thyroiditis
PubMed: 31151717
DOI: 10.1016/j.cjca.2019.03.013 -
American Family Physician Feb 2000Thyroiditis is a group of inflammatory thyroid disorders. Patients with chronic lymphocytic thyroiditis (also referred to as Hashimoto's thyroiditis) present with... (Review)
Review
Thyroiditis is a group of inflammatory thyroid disorders. Patients with chronic lymphocytic thyroiditis (also referred to as Hashimoto's thyroiditis) present with hypothyroidism, goiter, or both. Measurement of serum thyroid autoantibodies and thyroglobulin confirms the diagnosis. Subacute granulomatous thyroiditis (sometimes referred to as de Quervain's disease) is a self-limited but painful disorder of the thyroid. Physical examination, elevated erythrocyte sedimentation rate, elevated thyroglobulin level and depressed radioactive iodine uptake (RAIU) confirm the diagnosis. Subacute lymphocytic thyroiditis (silent thyroiditis) is considered autoimmune in origin and commonly occurs in the postpartum period. Symptoms of hyperthyroidism and depressed RAIU predominate. Acute (suppurative) thyroiditis is a rare, infectious thyroid disorder caused by bacteria and other microbes. The rare, invasive fibrous thyroiditis (Riedel's thyroiditis) presents with a slowly enlarging anterior neck mass that is sometimes confused with a malignancy.
Topics: Diagnosis, Differential; Humans; Patient Education as Topic; Teaching Materials; Thyroiditis; Thyroiditis, Autoimmune; Thyroiditis, Subacute
PubMed: 10706157
DOI: No ID Found