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post partum thyroid

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
Michael H Dahan, SeangLin Tan
The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid stimulating hormone (TSH), Adreno corticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond's disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopitiutaryism...
July 13, 2016: Minerva Ginecologica
Simone De Leo, Sun Y Lee, Lewis E Braverman
Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves' disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. Treatment options for Graves' disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation...
August 27, 2016: Lancet
Annemiek M C P Joosen, Ivon J M van der Linden, Neletta de Jong-Aarts, Marieke A A Hermus, Antonius A M Ermens, Monique J M de Groot
BACKGROUND: Trimester-specific reference intervals for TSH are recommended to assess thyroid function during pregnancy due to changes in thyroid physiology. Laboratories should verify reference intervals for their population and assay used. No consistent upper reference limit (URL) for TSH during pregnancy is reported in literature. We investigated the use of non-pregnant reference intervals for TSH, recommended during pregnancy by current Dutch guidelines, by deriving trimester-specific reference intervals in disease-free Dutch pregnant women as these are not available...
July 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
E Piantanida, A Lai, L Sassi, D Gallo, E Spreafico, M L Tanda, L Bartalena
Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas and is ultimately due to antibodies interacting with the TSH receptor on thyroid follicular cells [TSH-receptor antibody (TRAb)]. Antithyroid drugs (ATDs) belonging to the family of thionamides are the first-line treatment in Europe. ATD treatment is commonly continued for 18-24 months. Its major limitation is the high rate of relapses after drug withdrawal. Factors particularly bound to subsequent relapses are the large thyroid volume, smoking habit, persistence of TRAb in the circulation at the end of treatment, and the post-partum period...
September 2015: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Edoardo Guastamacchia, Vito Angelo Giagulli, Brunella Licchelli, Vincenzo Triggiani
Selenium and iodine are essential for thyroid hormone synthesis and function. Selenium, in form of selenocysteine, is found either in the catalytic center of enzymes involved in the protection of the thyroid gland from free radicals originating during thyroid hormone synthesis, and in three different iodothyronine deiodinases catalyzing the activation and the inactivation of thyroid hormones. Iodine is an essential constituent of thyroid hormones and its deficiency causes different disorders that include goiter, hypothyroidism, reduced fertility and alteration in growth, physical and neurological development...
2015: Endocrine, Metabolic & Immune Disorders Drug Targets
Shailesh Garg, Manuel Villa, Jaya Ruth Asirvatham, Thomas Mathew, Louis-Joseph Auguste
Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a rare cervical inflammatory lymphadenitis that is most commonly seen in young Asian women. It is mainly characterized by lymphadenopathy, hepatosplenomegaly, fever, nocturnal sweats, myalgia, weight loss, and arthralgia, and commonly follows a self-limited course. The differential diagnosis is challenging as many other conditions such as malignant lymphoma, metastatic disease, tuberculosis and infectious lymphadenopathies can present in a similar way...
June 2015: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
G Jean Harry, Michelle J Hooth, Molly Vallant, Mamta Behl, Gregory S Travlos, James L Howard, Catherine J Price, Sandra McBride, Ron Mervis, Peter R Mouton
Thyroid hormones (TH) regulate biological processes implicated in neurodevelopmental disorders and can be altered with environmental exposures. Developmental exposure to the dioxin-like compound, 3,3',4,4'-tetrachloroazobenzene (TCAB), induced a dose response deficit in serum T4 levels with no change in 3,5,3'- triiodothyronine or thyroid stimulating hormone. Female Sprague-Dawley rats were orally gavaged (corn oil, 0.1, 1.0, or 10 mg TCAB/kg/day) two weeks prior to cohabitation until post-partum day 3 and male offspring from post-natal day (PND)4-21...
September 2014: Toxics
Elizabeth N Pearce
An awareness of the gestational changes to thyroid physiology and the impact of uncontrolled thyroid disease on pregnancy and infant outcome is essential for the successful management of hypothyroidism and hyperthyroidism. This review summarizes strategies for the management of thyroid disease in pregnancy and post partum, and it highlights areas where there is still a lack of consensus.
July 2015: Best Practice & Research. Clinical Obstetrics & Gynaecology
Lorelle Weiss, Tye E Arbuckle, Mandy Fisher, Tim Ramsay, Ranjeeta Mallick, Russ Hauser, Alain LeBlanc, Mark Walker, Pierre Dumas, Carly Lang
BACKGROUND: Triclosan (TCS) is an antibacterial agent commonly added to personal care products. Some animal research studies have associated TCS exposure with androgenic and thyroid effects, as well as endocrine disruption, contact dermatitis and skin irritation. Limited Canadian data exist on exposure levels, temporal variability and sources of exposure to TCS, especially among pregnant women. METHODS: Single and serial spot urine samples (n=1249), as well as consumer product use information were collected over 5 study visits across pregnancy and post-partum from 80 healthy pregnant women in Ottawa, Canada...
August 2015: International Journal of Hygiene and Environmental Health
Inger Aakre, Trine Bjøro, Ingrid Norheim, Tor A Strand, Ingrid Barikmo, Sigrun Henjum
OBJECTIVES: Thyroid dysfunction can be a result of excessive iodine intake, which may have adverse health consequences, particularly for women in fertile age. In 2010, we conducted a cross-sectional study among lactating women with excessive iodine intake in the Saharawi refugee camps in Algeria and found a high prevalence of thyroid dysfunction. Three years later, we conducted a follow-up study to monitor the iodine situation and explore whether thyroid dysfunction still was highly prevalent when the women no longer were post-partum...
2015: Journal of Trace Elements in Medicine and Biology
Jesslyn Lu, Susan Samson, Joseph Kass, Nalini Ram
A previously healthy 36-year-old woman presented with visual hallucinations and acute psychosis manifested predominantly as hypersexuality. Laboratory testing demonstrated elevated free thyroxine levels, suppressed thyroid-stimulating hormone levels and presence of thyroid-stimulating immunoglobulin and thyroid peroxidase (TPO) antibodies consistent with Graves' disease. Despite achieving biochemical euthyroidism, she remained profoundly hypersexual. She did not respond to additional treatment with antipsychotics and corticosteroids, prompting further evaluation...
2015: BMJ Case Reports
Manish M George, Jay Goswamy, Susannah E Penney
BACKGROUND: The thyroid undergoes a variety of physiological changes during pregnancy. The relatively low iodine levels seen in pregnancy have been implicated in thyroid growth during this time. Management of thyroid cancer in pregnancy is not immediately apparent. Furthermore, acute suppurative thyroiditis is rare and this is attributed to the glands innate immunity. We thoroughly review the evidence regarding management of thyroid abscess and thyroid malignancy during pregnancy and illustrate it via an extremely rare case of an embolic thyroid abscess highlighting an underlying carcinoma in a pregnant woman...
2015: Thyroid Research
Robert Krysiak, Beata Kowalska, Bogusław Okopien
Vitamin D deficiency seems to be implicated in the onset and progression of some autoimmune disorders. No previous study has investigated vitamin D homeostasis in post-partum thyroiditis. We compared 25-hydroxyvitamin D and parathyroid hormone (PTH) levels between four groups of non-lactating women who gave birth within 12 months before the beginning of the study: hypothyroid women with post-partum thyroiditis (group A; n = 14), euthyroid females with post-partum thyroiditis (group B; n = 14), women with non-autoimmune hypothyroidism (group C; n = 16) and healthy euthyroid females without thyroid autoimmunity (group D; n = 15)...
June 2015: Basic & Clinical Pharmacology & Toxicology
Melissa Sergi, George Tomlinson, Denice S Feig
OBJECTIVE: Post-partum thyroiditis (PPT) is a common phenomenon in the general population. To date there have been few studies examining the incidence of PPT in women with hypothyroidism antedating pregnancy. This study aimed to assess the incidence and potential predictors of PPT in women with treated hypothyroidism antedating pregnancy. DESIGN: Retrospective cohort study. PATIENTS AND METHODS: We compiled a cohort of 97 women with previous hypothyroidism antedating pregnancy seen in the Endocrinology in Pregnancy clinic from 1999 to 2011, collecting data on thyroid function, antibodies and levothyroxine doses post-partum...
September 2015: Clinical Endocrinology
E I Ekinci, W-L Chiu, Z X Lu, K Sikaris, L Churilov, I Bittar, Q Lam, N Crinis, C A Houlihan
OBJECTIVE: Thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TGAb) are frequently measured to investigate thyroid dysfunction in pregnancy. Despite the recognized fall of these autoantibodies in pregnancy, there is limited guidance on the timing of such testing. We assessed optimal test timing of TPOAb/TGAb for the detection of Hashimoto's thyroiditis and post-partum thyroid dysfunction (PPTD). DESIGN: Prospective longitudinal study with recruitment in Trimester 1...
April 2015: Clinical Endocrinology
Serap B Sahin, Sabri Ogullar, Ulku Mete Ural, Kadir Ilkkilic, Yavuz Metin, Teslime Ayaz
OBJECTIVE: The effects of pregnancy on thyroid nodules were investigated in a few number of studies. We aimed to evaluate the prevalence of thyroid nodules, the changes in size, volume and number of nodules during pregnancy and after delivery in pregnant women. DESIGN AND METHODS: This prospective study was performed in a severe iodine-deficient area and included 83 pregnant women (mean age 30·4 ± 5·5 years). We evaluated thyroid hormone levels, ultrasound examination of thyroid and urine iodine concentration (UIE) at each trimester and at 3-month post-partum period (PP)...
November 2014: Clinical Endocrinology
John H Lazarus
Risks to mother, fetus and neonate from untreated Graves' hyperthyroidism during gestation are compelling reasons for recommending pre-conception counselling. Pre-conception counselling should include discussion as to the optimum treatment of Graves' hyperthyroidism in women wishing to become pregnant. Thyrotropin receptor antibodies remain elevated following radioiodine therapy, so medical or surgical treatment may be preferred to avoid fetal or neonatal hyperthyroidism. A TSH level <2.5 mIU/l must be achieved in women receiving LT4 before conception...
April 2012: European Thyroid Journal
David S Cooper, Peter Laurberg
Changes in thyroid hormone concentrations that are characteristic of hyperthyroidism must be distinguished from physiological changes in thyroid hormone economy that occur in pregnancy, especially in the first trimester. Approximately one to two cases of gestational hyperthyroidism occur per 1000 pregnancies. Identification of hyperthyroidism in a pregnant woman is important because adverse outcomes can occur in both the mother and the offspring. Graves' disease, which is autoimmune in nature, is the usual cause; but hyperthyroidism in pregnancy can be caused by any type of hyperthyroidism--eg, toxic multinodular goitre or solitary autonomously functioning nodule...
November 2013: Lancet Diabetes & Endocrinology
F De Rensis, F López-Gatius
Equine chorionic gonadotropin (eCG) is a member of the glycoprotein family of hormones along with LH, FSH and thyroid-stimulating hormone. In non-equid species, eCG shows high LH- and FSH-like activities and has a high affinity for both FSH and LH receptors in the ovaries. On the granulosa and thecal cells of the follicle, eCG has long-lasting LH- and FSH-like effects that stimulate oestradiol and progesterone secretion. Thus, eCG administration in dairy cattle results in fewer atretic follicles, the recruitment of more small follicles showing an elevated growth rate, the sustained growth of medium and large follicles and improved development of the dominant and pre-ovulatory follicle...
April 2014: Reproduction in Domestic Animals, Zuchthygiene
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