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Thyroid disease in pregnancy

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https://www.readbyqxmd.com/read/28203373/a-silent-skull-metastatic-follicular-thyroid-carcinoma-mimicking-as-a-benign-scalp-tumor-in-a-pregnant-woman
#1
Tsung-Chun Huang, Yu-Kai Cheng, Tsung-Wei Chen, Yung-Chang Hsu, En-Wei Liu, Hsin-Han Chen
: Thyroid cancer with cranial metastasis in a pregnant woman is very rare. In the literature, most cases are diagnosed early from neurogenic signs or symptomatic thyroid gland. Pregnancy also contributes to a hesitation toward early surgical and medical treatments. We reported a scalp tumor in a physically healthy 37-year-old pregnant female with a follicular thyroid carcinoma (FTC) with lung, bone and cranial metastasis in initial presentation. Silent neurogenic and physical examinations make an early diagnosis very challenging...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28153744/thyroid-stimulating-hormone-tsh-%C3%A2-2-5mu-l-in-early-pregnancy-prevalence-and-subsequent-outcomes
#2
David M Carty, Flora Doogan, Paul Welsh, Anna F Dominiczak, Christian Delles
OBJECTIVE: There remains controversy over how women with abnormal thyroid function tests in pregnancy should be classified. In this study we assessed the proportion of women with thyroid stimulating hormone (TSH)≥2.5mU/l in a large obstetric cohort, and examined how many have gone on to develop thyroid disease in the years since their pregnancy. STUDY DESIGN: 4643 women were recruited and samples taken in early pregnancy between 2007 and 2010. Thyroid function tests were analysed in 2014; in women with raised TSH computerised health records and prescription databases were used to identify thyroid disease detected since pregnancy...
January 25, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28139946/multiple-sclerosis-in-pregnancy-prevalence-sociodemographic-features-and-obstetrical-outcomes
#3
Alex Fong, Cindy T Chau, Cara Quant, Jennifer Duffy, Deyu Pan, Dotun A Ogunyemi
OBJECTIVE: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy. STUDY DESIGN: A retrospective cohort study was performed using deliveries in California from 2001-2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders. RESULTS: 1,185 out of 4,424,049 deliveries were complicated by MS...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28060899/longitudinal-profiles-of-thyroid-hormone-parameters-in-pregnancy-and-associations-with-preterm-birth
#4
Lauren E Johns, Kelly K Ferguson, Thomas F McElrath, Bhramar Mukherjee, Ellen W Seely, John D Meeker
INTRODUCTION: Overt thyroid disease in pregnancy is associated with numerous maternal and neonatal complications including preterm birth. Less is known about the contribution of trimester-specific subclinical alterations in individual thyroid hormones, especially in late gestation, on the risk of preterm birth. Herein, we examined the associations between subclinical changes in maternal thyroid hormone concentrations (TSH, total T3, free and total T4), measured at multiple time points in pregnancy, and the odds of preterm birth in pregnant women without clinical thyroid disease...
2017: PloS One
https://www.readbyqxmd.com/read/28056690/2016-guidelines-of-the-american-thyroid-association-for-the-diagnosis-and-management-of-thyroid-disease-during-pregnancy-and-the-postpartum
#5
Erik K Alexander, Elizabeth N Pearce, Gregory A Brent, Rosalind S Brown, Herbert Chen, Chrysoula Dosiou, William Grobman, Peter Laurberg, John H Lazarus, Susan J Mandel, Robin Peeters, Scott Sullivan
BACKGROUND: Thyroid disease in pregnancy is a common clinical problem. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception and the postpartum period...
January 6, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28049387/stimulation-of-thyroid-function-by-human-chorionic-gonadotropin-during-pregnancy-a-risk-factor-for-thyroid-disease-and-a-mechanism-for-known-risk-factors
#6
Tim I M Korevaar, Yolanda B de Rijke, Layal Chaker, Marco Medici, Vincent W V Jaddoe, Eric A P Steegers, Theo J Visser, Robin P Peeters
BACKGROUND: Thyroid autoimmunity is a major risk factor for gestational thyroid disease, and recently various other risk factors have been identified, including maternal age, body mass index (BMI) and parity. Human chorionic gonadotropin (hCG) is an important determinant of gestational thyroid function, yet it is unknown to what extent differences in hCG concentration affect the risk for thyroid disease. We have recently shown that thyroperoxidase antibody positivity impairs the thyroidal response to hCG stimulation, which may suggest that this is a mechanism through which thyroid autoimmunity acts as a risk factor for thyroid disease...
February 8, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27994875/management-of-metastatic-thyroid-cancer-in-pregnancy-risk-and-uncertainty
#7
Christopher W Rowe, Kirsten Murray, Andrew Woods, Sandeep Gupta, Roger Smith, Katie Wynne
: Metastatic thyroid cancer is an uncommon condition to be present at the time of pregnancy, but presents a challenging paradigm of care. Clinicians must balance the competing interests of long-term maternal health, best achieved by iatrogenic hyperthyroidism, regular radioiodine therapy and avoidance of dietary iodine, against the priority to care for the developing foetus, with inevitable compromise. Additionally, epidemiological and cellular data support the role of oestrogen as a growth factor for benign and malignant thyrocytes, although communicating the magnitude of this risk to patients and caregivers, as well as the uncertain impact of any pregnancy on long-term prognosis, remains challenging...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27978517/management-of-fetal-and-neonatal-graves-disease
#8
Juliane Léger
Fetal and neonatal autoimmune hyperthyroidism is a rare, serious but transient disorder. Early diagnosis and treatment are key objectives for an optimal prognosis and the well-being of the child. This review focuses on the management of these patients during the fetal and neonatal periods. We propose a diagnostic algorithm for high-risk pregnancies in mothers with current or past hyperthyroidism related to Graves' disease, involving repeated fetal thyroid gland assessments from 20 weeks of gestation onwards and maternal serum thyroid-stimulating hormone receptor antibody (TRAb) determination, with close monitoring if TRAb levels exceed 2 to 3 times the upper limit of the normal range...
December 16, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27967219/a-survey-of-clinical-practice-patterns-in-management-of-graves-disease-in-the-middle-east-and-north-africa
#9
Salem A Beshyah, Aly B Khalil, Ibrahim H Sherif, Mahmoud M Benbarka, Syed Abbas Raza, Wiam Hussein, Ali S Alzahrani, Asma Chadli
OBJECTIVES: Graves' disease (GD) is commonly seen in endocrine clinical practice. The objective of this study was to evaluate the current diagnosis and management of patient's with GD in the Middle East and North Africa (MENA). METHODOLOGY: An electronic survey on management of GD, using an online questionnaire of a large pool of practicing physicians was performed. Responses from 352 eligible and willing physicians were included in this study. They were mostly endocrinologists (157) and internal medicine physicians (116)...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27917035/polyglandular-autoimmune-syndrome-in-pregnancy-case-report
#10
Basilio Pecorino, Maria Cristina Teodoro, Paolo Scollo
Type III Polyglandular Autoimmune Syndrome is a multiple endocrine disorders disease determined by autoimmunity; it can be diagnosed if a patient is affected by Type 1 Diabetes Mellitus and another autoimmune disease, except Addison Disease, for example Autoimmune Hashimoto Thyroiditis or Celiac Disease. R.D., 34-year-old woman (gravida 2 para 1), was referred to the High Risk Pregnancy Outpatient Clinic at Cannizzaro Hospital in Catania at 8 weeks' gestation. She was affected from type III Polyglandular Autoimmune Disease (Type 1 Diabetes Mellitus, Autoimmune Hashimoto Thyroiditis and Celiac Disease)...
September 2016: Italian Journal of Gynaecology & Obstetrics: Official Publication of the Societa Italiana di Ginecologia e Ostetricia (SIGO)
https://www.readbyqxmd.com/read/27913562/relationship-between-maternal-hypoglycaemia-and-small-for-gestational-age-infants-according-to-maternal-weight-status-a-retrospective-cohort-study-in-two-hospitals
#11
Satoshi Shinohara, Yuzo Uchida, Mitsuo Hirai, Shuji Hirata, Kohta Suzuki
OBJECTIVE: The relationship between pre-pregnancy body mass index (BMI) and low glucose challenge test (GCT) results by maternal weight status has not been examined. This study aimed to clarify the relationship between a low GCT result and small for gestational age (SGA) by maternal weight status. DESIGN: A retrospective cohort study in 2 hospitals. SETTING: This study evaluated the obstetric records of women who delivered in a general community hospital and a tertiary perinatal care centre...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27901552/diagnosis-and-management-of-hyperthyroidism-in-pregnancy-a-review
#12
Jennifer Renae King, Ruben Lachica, Richard H Lee, Martin Montoro, Jorge Mestman
Importance: Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. Objective: To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27879326/effects-of-levothyroxine-treatment-on-pregnancy-outcomes-in-pregnant-women-with-autoimmune-thyroid-disease
#13
RANDOMIZED CONTROLLED TRIAL
Sima Nazarpour, Fahimeh Ramezani Tehrani, Masoumeh Simbar, Maryam Tohidi, Hamid Alavi Majd, Fereidoun Azizi
BACKGROUND: Despite some studies indicating that thyroid antibody positivity during pregnancy has been associated with adverse pregnancy outcomes, evidence regarding the effects of levothyroxine (LT4) treatment of euthyroid/subclinical hypothyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. We aimed to assess whether pregnant women with autoimmune thyroid disease, but without overt thyroid dysfunction are affected by higher rates of adverse pregnancy outcomes...
February 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27865435/the-pulse-mass-index-as-a-predictor-of-cardiovascular-events-in-women-with-systemic-lupus-erythematosus
#14
Elsy Aidé García-Villegas, Horacio Márquez-González, Luis Felipe Flores-Suárez, Antonio Rafael Villa-Romero
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE. METHODOLOGY: Cohort study...
January 20, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/27843806/a-2016-italian-survey-about-the-clinical-use-of-selenium-in-thyroid-disease
#15
Roberto Negro, Roberto Attanasio, Franco Grimaldi, Claudio Marcocci, Rinaldo Guglielmi, Enrico Papini
BACKGROUND: Selenium (Se) is a trace element that plays key roles in thyroid physiology. Se deficiency is associated with increased risk of thyroid disease. Some evidence suggests that Se supplementation may be beneficial in autoimmune thyroid disease (either hypo- or hyperthyroidism). OBJECTIVES: We sought to examine the use of Se in daily clinical practice among Italian endocrinologists. METHODS: Members of the Associazione Medici Endocrinologi (AME) were invited to participate in a web-based survey investigating the use of Se in different clinical conditions...
September 2016: European Thyroid Journal
https://www.readbyqxmd.com/read/27835925/response-to-therapy-status-is-an-excellent-predictor-of-pregnancy-associated-structural-disease-progression-in-patients-previously-treated-for-differentiated-thyroid-cancer
#16
Luba Rakhlin, Stephanie Fish, R Michael Tuttle
BACKGROUND: Pregnancy may be associated with an increased risk of recurrence/progression of differentiated thyroid cancer (DTC). However, it is unclear if the impact of pregnancy would differ based on pre-pregnancy response to therapy status. The objective of this study was to investigate the risk of recurrence/progression of DTC, applying the response to therapy assessments to pre-pregnancy status as recommended by the 2015 American Thyroid Association thyroid cancer guidelines. METHODS: This was a retrospective review of 235 women followed at Memorial Sloan Kettering Cancer Center for DTC who had a term pregnancy after initial treatment for DTC between 1997 and 2015...
January 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27813690/fetal-neonatal-thyrotoxicosis-in-a-newborn-from-a-hypothyroid-woman-with-hashimoto-s-thyroiditis
#17
Florian W Kiefer, Katrin Klebermass-Schrehof, Manuel Steiner, Christof Worda, Gregor Kasprian, Tanja Diana, George J Kahaly, Alois Gessl
CONTEXT: Fetal/neonatal thyrotoxicosis is a rare but potentially life-threatening condition. It is most commonly observed in poorly controlled Graves' disease during pregnancy. CASE DESCRIPTION: Here we describe the first reported case of thyrotoxicosis in a fetus/newborn from a woman with Hashimoto's thyroiditis and levothyroxine-treated hypothyroidism. Transplacental passage of stimulating TSH-receptor antibodies, measured by a cell-based bioassay, was the underlying mechanism of fetal/neonatal thyrotoxicosis even though the mother had no history of hyperthyroidism...
November 4, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27809623/onset-of-graves-disease-during-pregnancy-in-a-woman-with-established-hypothyroidism
#18
María Alberiche, Rosa María Sánchez-Hernández, Xabier López Mérida, Ana María Wägner
BACKGROUND: Pregnancy strongly influences the thyroid gland and its function. Thyroid guidelines recommend a 30 to 50% increase of the preconceptional levothyroxine dose in women with hypothyroidism, when pregnancy is diagnosed. CASE: A 33 year-old, 8-week pregnant woman with hypothyroidism, presents with a 2-week history of palpitations, sweating, nervousness and fatigue. Physical examination shows tachycardia (108 bpm), distal tremors and diffuse goiter. After biochemical confirmation of hyperthyroidism, her levothyroxine dose is reduced and finally interrupted...
January 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27805280/iodine-deficiency-amongst-pregnant-women-in-south-west-england
#19
Bridget A Knight, Beverley M Shields, Xuemei He, Elizabeth N Pearce, Lewis E Braverman, Rachel Sturley, Bijay Vaidya
INTRODUCTION: Iodine deficiency in pregnancy may impair foetal neurological development. The UK population is generally thought to be iodine sufficient; however, recent studies have questioned this assumption. Our study aimed to explore the prevalence of iodine deficiency in a cohort of pregnant mothers from South-West England. METHODS: Urine samples were obtained from 308 women participating in a study of breech presentation in late pregnancy. They had no known thyroid disease and a singleton pregnancy at 36-38 weeks' gestation...
March 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/27790717/in-utero-coxsackievirus-b4-infection-of-the-mouse-thymus
#20
H Jaïdane, A Halouani, H Jmii, F Elmastour, S Abdelkefi, G Bodart, H Michaux, T Chakroun, F Sane, M Mokni, V Geenen, D Hober, M Aouni
Type B coxsackievirus (CV-B) infections are involved frequently in the triggering of several autoimmune diseases such as myocarditis, dilated cardiomyopathy, pericarditis, pancreatitis, type 1 diabetes, encephalitis, thyroiditis or Sjögren's syndrome. Serological and virological evidence suggests that maternal infections during pregnancy can play a role in the appearance of these diseases in offspring. The current study aims to explore the effect of an in-utero CV-B infection on the fetal thymus, the central site for programming immunological self-tolerance...
March 2017: Clinical and Experimental Immunology
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