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Postpartum Thyroiditis

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https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#1
Carolina M Perdomo, Jorge A Árabe, Miguel Á Idoate, Juan C Galofré
INTRODUCTION: Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects. MATERIALS AND METHODS: We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery...
December 2, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27901552/diagnosis-and-management-of-hyperthyroidism-in-pregnancy-a-review
#2
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/27886341/clinical-efficacy-of-therapeutic-intervention-for-subclinical-hypothyroidism-during-pregnancy
#3
R Ju, L Lin, Y Long, J Zhang, J Huang
This study explored the effects of levothyroxine (L-T4) replacement therapy on pregnancy outcomes in patients with subclinical hypothyroidism (SCH). We analyzed the effects on pregnancy outcomes with respect to gestational week when the desired thyroid-stimulating hormone (TSH) level was reached as well as the length of time required to reach the target level during L-T4 treatment. This study enrolled 457 patients diagnosed with SCH upon initial thyroid function screening. Subjects were assigned to the treatment group (N = 184), and the control group (N = 273)...
November 21, 2016: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/27809623/onset-of-graves-disease-during-pregnancy-in-a-woman-with-established-hypothyroidism
#4
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...
November 4, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27808580/recurrence-of-phaeochromocytoma-in-pregnancy-in-a-patient-with-multiple-endocrine-neoplasia-2a-a-case-report-and-review-of-literature
#5
Efterpi Tingi, Angelos Kyriacou, Lynda Verghese
Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant inherited condition with a prevalence of one in 40 000 individuals. It causes the development of tumours in endocrine glands, such as medullary thyroid cancer, pheochromocytomas, as well as primary hyperparathyroidism. MEN 2A in pregnancy is very rare with only 29 cases reported in the literature. The presence of pheochromocytoma is a rare cause of hypertension during pregnancy with an incidence of 0.007% of all pregnancies. This has severe implications on both mother and the foetus...
November 3, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27806973/neonatal-thyrotropin-concentration-and-iodine-nutrition-status-of-mothers-a-systematic-review-and-meta-analysis
#6
Pantea Nazeri, Parvin Mirmiran, Ali Kabir, Fereidoun Azizi
BACKGROUND: Low maternal iodine intake disturbs the thyroid function of neonates transiently or permanently. OBJECTIVE: To our knowledge, we conducted one of the first systematic reviews and meta-analyses aimed at exploring the association of neonatal thyrotropin concentrations and iodine status of mothers during pregnancy and early postpartum periods. DESIGN: Data were collected through literature searches for studies published between 1969 and 2015 with the use of electronic databases...
November 2, 2016: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27790523/the-effect-of-anti-thyroid-peroxidase-antibodies-on-pregnancy-outcomes-in-euthyroid-women
#7
Monika Meena, Seema Chopra, Vanita Jain, Neelam Aggarwal
INTRODUCTION: Thyroid autoimmunity can have an adverse impact on the outcome of the pregnancy. Although the adverse effects of antithyroid antibodies have been well studied in hypothyroid women, their effects in euthyroid women are not well evaluated. AIM: The study was conducted to assess the overall prevalence of anti-Thyroid Peroxidase (anti-TPO) antibodies in pregnant women and the effect of anti-TPO positivity on the outcome of pregnancy in euthyroid women...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27784851/postpartum-hypothalamic-adrenal-insufficiency-with-remission-a-rare-case
#8
Yuko Akehi, Yoko Hashimoto, Junko Meren, Makito Tanabe, Takashi Nomiyama, Toshihiko Yanase
A 37-year-old female patient was hospitalized because of general fatigue and loss of axillary and pubic hair after massive bleeding at delivery of her third child. The basal levels of both plasma adrenocorticotropin hormone (ACTH) and serum cortisol were very low, 5.2 pg/mL and 1.9 μg/dL, respectively. Based on the fact that ACTH showed a low response to insulin tolerance test and a normal response to corticotropin-releasing hormone (CRH), she was diagnosed with hypothalamic adrenal insufficiency. No organic lesions were found in the hypothalamic-pituitary region by pituitary MRI and hydrocortisone therapy was instituted...
October 25, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/27760010/effect-of-nitrates-thiocyanates-and-selenium-on-the-iron-and-iodine-status-of-postpartum-women
#9
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
https://www.readbyqxmd.com/read/27741551/thyroid-cancer-in-pregnancy
#10
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...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27741549/management-of-hyperthyroidism-during-the-preconception-phase-pregnancy-and-the-postpartum-period
#11
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...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27734704/-vitamin-d-and-autoimmune-thyroid-diseases
#12
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
https://www.readbyqxmd.com/read/27734702/-psycho-immuno-endocrinology-of-the-thyroid-gland
#13
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
https://www.readbyqxmd.com/read/27733101/reference-intervals-of-thyroid-function-during-pregnancy-self-sequential-longitudinal-study-vs-cross-sectional-study
#14
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
https://www.readbyqxmd.com/read/27659896/pregnancy-and-the-hair-growth-cycle-anagen-induction-against-hair-growth-disruption-using-nourkrin-%C3%A2-with-marilex-%C3%A2-a-proteoglycan-replacement-therapy
#15
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
https://www.readbyqxmd.com/read/27618605/no-definitive-evidence-for-a-connection-between-autoimmune-thyroid-diseases-and-stress-in-women
#16
Lisandra Damian, Cristina Mihaela Ghiciuc, Lucia Corina Dima-Cozma, Maria Christina Ungureanu, Sebastian Cozma, Francesca Romana Patacchioli, Catalina Elena Lupusoru
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 16, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27609245/postpartum-psychosis-madness-mania-and-melancholia-in-motherhood
#17
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...
December 1, 2016: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27583841/spontaneous-intrathyroidal-hematoma-causing-airway-obstruction-a-case-report
#18
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)
https://www.readbyqxmd.com/read/27578976/higher-minor-hemoglobin-a2-levels-in-multiple-sclerosis-patients-correlate-with-lesser-disease-severity
#19
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
https://www.readbyqxmd.com/read/27561657/antithyroid-drugs-during-breastfeeding
#20
Bartosz Hudzik, Barbara Zubelewicz-Szkodzinska
Antithyroid drugs (ATDs) 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...
December 2016: Clinical Endocrinology
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