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Postpartum Thyroiditis

Anelia V Bivolarska, Ana I Maneva, Penka D Gatseva, Mariana N Katsarova
AIM: To find correlations between high thiocyanate and nitrate levels and low selenium levels and the indicators of the iodine and iron status of postpartum women. MATERIALS AND METHODS: The study included 41 mothers aged 26.4±5.9 yrs from Asenovgrad and nearby villages. Urinary iodine was determined by the Sandell-Kolthoff reaction and thiocyanate - by the interaction of these ions with acidic solution of KMnO4; for serum nitrates we used the colorimetric method; serum selenium was assessed by electro-thermal atomic-absorption spectrophotometry; thyroxin (FT4), the thyroid stimulating hormone (TSH), serum ferritin (SF), and serum transferrin receptor (sTfR) were determined using ELISA; Hb levels were determined by hematology analyzer...
September 1, 2016: Folia Medica
Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
October 14, 2016: Seminars in Reproductive Medicine
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Karel Vondra
From the recent literature data it may be concluded that vitamin D deficiency is associated with increased risk of thyroid autoimmunity development and thus should be considered as an additional important risk factor for both chronic autoimmune thyroiditis (postpartum thyroiditis including) and Graves´ disease. A higher risk of Graves´ disease development is also associated with several polymorphisms in the gene encoding for vitamin D binding protein and for the specific receptor of active form of vitamin D - 1,25-(OH)2D3 in the respective target cells...
2016: Vnitr̆ní Lékar̆ství
Ivan Šterzl, Karolína Absolonová, Petr Matucha
Historically endocrinologists and psychiatrists are aware that disturbances in thyroid disease in beginning or even in clinically intensified states of thyrotoxicosis or hypothyroidism exhibit pathological mental manifestations, masking or potentiating the underlying disease. Immune system disorders cause thyroid organ-specific autoimmune process. This autoimmune thyroid disease binds with a number of disorders in both endocrine or non-endocrine organs. This appears in vascular, neurological, skin, connective tissue, gastrointestinal tract and mental pathology...
2016: Vnitr̆ní Lékar̆ství
Xiaomei Zhang, Baoting Yao, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Xiaochun Teng, Cheng Han, Weiwei Zhou, Chenyang Li, Bin Xu, Lihua Bi, Tao Meng, Jianling Du, Shaowei Zhang, Zhengnan Gao, Liu Yang, Chenling Fan, Weiping Teng, Zhongyan Shan
BACKGROUND: Self-sequential longitudinal reference interval may be expected to minimize the inter-individual variation of thyroid function. Comparison between self-sequential longitudinal reference interval and cross-sectional reference interval in pregnancy has not been well investigated. The objective of this study is to establish a stringent self-sequential longitudinal reference interval (SLRI) of thyroid function in pregnant women and to compare it with the conventional cross-sectional reference interval (CSRI)...
October 12, 2016: Thyroid: Official Journal of the American Thyroid Association
Erling Thom
Postpartum effluvium is a well-known clinical fact. However, following some minor research activities in the 1960s, very little has happened on the research front of the subject. It was hypothesized that postpartum hair loss might be a manifestation of a change in the hair growth cycle occurring normally during pregnancy. Recently, new research has been published trying to explain the mechanism of action behind this frequently occurring hair growth disruption, and to develop a functional treatment schedule and regime...
September 23, 2016: Journal of Cosmetic Dermatology
Lisandra Damian, Cristina Mihaela Ghiciuc, Lucia Corina Dima-Cozma, Maria Christina Ungureanu, Sebastian Cozma, Francesca Romana Patacchioli
The purpose of this literature review was to examine the available clinical studies performed during the last 15 years to identify if there is a causal relationship between the onset and course of autoimmune thyroid diseases (AITDs) and the hypothalamic-pituitary-adrenal (HPA) axis/sympathetic-adrenomedullary system (SAM) (dys)function in women. Using the PubMed, Web of Science and Scopus databases, a comprehensive search was performed, and 14 articles were finally identified. The majority of selected studies suggested a causal connection between Graves' Disease (GD) and stress, as well as between Hashimoto Thyroiditis (HT), with its variant postpartum thyroiditis, and stress...
July 12, 2016: Neuro Endocrinology Letters
Veerle Bergink, Natalie Rasgon, Katherine L Wisner
OBJECTIVE: Psychosis or mania after childbirth is a psychiatric emergency with risk for suicide and infanticide. METHOD: The authors reviewed the epidemiologic and genetic research and physiological postpartum triggers (endocrine, immunological, circadian) of psychosis. They also summarized all systematic reviews and synthesized the sparse clinical studies to provide diagnostic recommendations, treatment options, and strategies for prevention. RESULTS: The incidence of first-lifetime onset postpartum psychosis/mania from population-based register studies of psychiatric admissions varies from 0...
September 9, 2016: American Journal of Psychiatry
Corliss A E Best, Sandeep Dhaliwal, Samantha Tam, T Hubert Low, Brian Hughes, Kevin Fung, S Danielle MacNeil
INTRODUCTION: Spontaneous thyroid hemorrhage is a rare occurrence that results in pain, discomfort, and occasionally compressive symptoms. Infrequently, extensive thyroid hemorrhage can result in a rapidly expanding hematoma resulting in airway compromise. This is a case of an otherwise healthy young woman, 3 months postpartum, with a slowly expanding spontaneous thyroid hemorrhage that measured at 7 × 5.5 × 5 cm by computed tomography. She ultimately required intubation to manage respiratory distress and subsequently a hemithyroidectomy for definitive treatment...
August 2016: Medicine (Baltimore)
Muhammed Emin Ozcan, Bahri Ince, Hasan Huseyin Karadeli, Asuman Gedikbasi, Talip Asil, Meric A Altinoz
OBJECTIVE: To define whether minor adult hemoglobin A2 (HbA2, α2δ2) exerts any protective activity in multiple sclerosis (MS). METHODS: HbA2 levels were measured in 146 MS patients with high performance liquid chromatography and association with MS Severity Scores (MSSS) were determined. HbA2 associations with blood count parameters were also studied using blood counts evaluated on the same day of high performance liquid chromatography sampling. Routine biochemical parameters were also determined to rule out elusively influential factors, such as anemia and thyroid disorders...
2016: Neuropsychiatric Disease and Treatment
Bartosz Hudzik, Barbara Zubelewicz-Szkodzinska
Antithyroid drugs (ATD) are widely used for the treatment of Graves' disease (GD) in the general population. Over the past decade there has been an increasing awareness that several disturbances of thyroid function may occur in mothers after delivery which may be more prevalent than previously appreciated. Exacerbation of immune reactions occurs 3-12 month following delivery. Management of hyperthyroidism during lactation requires special considerations and should be implemented to prevent any adverse outcomes in mother and neonate...
August 26, 2016: Clinical Endocrinology
Claudia Teti, Elena Nazzari, Marina Galletti, Mattia Grazia Mandolfino, Francesca Pupo, Giampaola Pesce, Flavia Lillo, Marcello Bagnasco, Salvatore Benvenga
BACKGROUND: The use of thyrotropin and free thyroid hormone assays to evaluate thyroid function is widespread, but in some situations the results are inconsistent with the patient's thyroid status. SUMMARY: A 35-year-old woman with a known diagnosis of chronic autoimmune thyroiditis was referred to us at week 26 of her second pregnancy. The patient was clinically euthyroid; consistent with this, her serum TSH was normal (0.79 mU/L), but she had elevated free thyroid hormones (fT3, fT4), as determined by a one-step chemiluminescent assay...
August 18, 2016: Thyroid: Official Journal of the American Thyroid Association
Xiaowen Zhang, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Shiqiao Peng, Zhaojun Wang, Cheng Han, Xiaomei Zhang, Danyang Wang, Chenling Fan, Zhongyan Shan, Weiping Teng
OBJECTIVES: To describe the changes in thyroglobulin (Tg) based upon gestational and postpartum concentrations in healthy pregnant women from an iodine-sufficient region in China, and to evaluate the use of Tg as a biomarker for iodine-sufficient pregnant women. DESIGN: A longitudinal study of Tg change in normal pregnant women from an iodine-sufficient region. PATIENTS AND MEASUREMENTS: Blood and urine samples were obtained from 133 pregnant women...
August 13, 2016: Clinical Endocrinology
S L Andersen, A Carlé, J Olsen, P Laurberg
OBJECTIVE: Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. DESIGN: Population-based cohort study using Danish nationwide registers. METHOD: All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted...
November 2016: European Journal of Endocrinology
Hans Wolff, Tobias W Fischer, Ulrike Blume-Peytavi
BACKGROUND: Hair loss is caused by a variety of hair growth disorders, each with its own pathogenetic mechanism. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed, on the current German and European guidelines, and on the authors' clinical and scientific experience. RESULTS: Excessive daily hair loss (effluvium) may be physiological, as in the postpartum state, or pathological, due for example to thyroid disturbances, drug effects, iron deficiency, or syphilis...
May 27, 2016: Deutsches Ärzteblatt International
Tetsuya Mizokami, Shuji Fukata, Akira Hishinuma, Takahiko Kogai, Katsuhiko Hamada, Tetsushi Maruta, Kiichiro Higashi, Junichi Tajiri
BACKGROUND: Iodide transport defect (ITD) is a dyshormonogenetic congenital hypothyroidism caused by sodium/iodide symporter (NIS) gene mutations. In the lactating mammary gland, iodide is concentrated by NIS, and iodine for thyroid hormone synthesis is thereby supplied to the infant in the breast milk. CASE DESCRIPTION: A 34-year-old Japanese woman was diagnosed with ITD caused by a homozygous NIS gene mutation T354P. She had begun treatment of primary hypothyroidism with levothyroxine at the age of 5...
July 2016: European Thyroid Journal
Akane Ide, Nobuyuki Amino, Eijun Nishihara, Takumi Kudo, Mitsuru Ito, Yukiko Kimura, Nobuya Tatsumi, Mineo Yamazaki, Akira Miyauchi
Graves' disease often occurs after delivery. However, it has been difficult to predict who will develop Graves' hyperthyroidism. We attempted to predict postpartum onset of Graves' disease by measuring anti-TSH receptor antibodies (TRAb) and thyroid-stimulating antibodies (TSAb) in early pregnancy. TRAb was measured by a third generation assay and TSAb was measured by a newly developed sensitive bioassay. In 690 early pregnant women, 2 showed borderline TRAb positive reactions. However, none of them developed Graves' disease after delivery...
July 12, 2016: Endocrine Journal
Faruk Uguz, Verinder Sharma
OBJECTIVE: This review examined the safety of mood stabilizers in exposed breastfed infants. METHODS: PubMed was searched for English language reports between 1 January 1995 and 30 August 2015 by using combinations of key words breastfeeding, lactation, postpartum period, puerperium, mood stabilizers, lithium, lamotrigine, valproate, carbamazepine, and oxcarbazepine. Case reports, case series, and prospective or cross-sectional studies including relevant data such as relative infant dose, milk-to-plasma ratio, infant drug plasma levels, and adverse events were identified...
June 2016: Bipolar Disorders
Simona Gaberšček, Jasna Osolnik, Katja Zaletel, Edvard Pirnat, Sergej Hojker
OBJECTIVES: To evaluate the diagnostic value of spectral Doppler sonography in women with thyroid dysfunction during the first postpartum year. METHODS: This prospective observational clinical study included 83 consecutive untreated women: 32 with hyperthyroid postpartum thyroiditis, 32 with hypothyroid postpartum thyroiditis, and 19 with Graves disease, which first appeared within 12 months after delivery. Thyrotropin, free thyroid hormones, thyroid peroxidase antibodies, thyroglobulin antibodies, and thyrotropin receptor antibodies were measured...
July 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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