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hyperthyroidism pregnancy

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https://www.readbyqxmd.com/read/28102101/thyroid-in-pregnancy-from-physiology-to-screening
#1
Drahomira Springer, Jan Jiskra, Zdenka Limanova, Tomas Zima, Eliska Potlukova
Thyroid hormones are crucial for the growth and maturation of many target tissues, especially the brain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential for fetal development as it supplies thyroid hormone-dependent tissues. The ontogeny of mature thyroid function involves organogenesis, and maturation of the hypothalamus, pituitary and the thyroid gland; and it is almost complete by the 12th-14th gestational week. In case of maternal hypothyroidism, substitution with levothyroxine must be started in early pregnancy...
January 19, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28079354/effect-of-excess-iodine-intake-on-thyroid-on-human-health
#2
Eftychia G Koukkou, Nikolaos D Roupas, Kostas B Markou
INTRODUCTION: The recommended daily intake of iodide, is 150 μg for adolescents and adults, 175 μg for pregnancy and 200 μg for lactation. Thyroid gland is an effective collector of iodine. EVIDENCE ACQUISITION: The active iodine uptake along the basolateral membrane of thyroid cell is followed by its transport to the apical edge of the cell and then to the follicle lumen. TSH acts through cAMP and stimulates NIS gene expression and protein synthesis. The major proportion of iodine in the thyroid gland is bound to Thyroglobulin...
January 12, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28049387/stimulation-of-thyroid-function-by-hcg-during-pregnancy-a-risk-factor-for-thyroid-disease-and-a-mechanism-for-known-risk-factors
#3
Tim Korevaar, Yolanda B de Rijke, Layal Chaker, Marco Medici, Vincent Wv Jaddoe, Eric Ap Steegers, Theo J Visser, Robin 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, BMI and parity. 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 TPOAb 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...
January 3, 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
#4
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
#5
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/27966300/relationship-between-gestational-transient-thyrotoxicosis-and-vitamin-d
#6
Ferit Kerim Küçükler, Yasin Şimşek, Ümit Görkem, Berçem Ayçiçek Doğan, Serdar Güler
BACKGROUND/AIM: Gestational transient thyrotoxicosis (GTT) is a transient, mild hyperthyroidism that occurs early in pregnancy and is due to human chorionic gonadotropin. There is no clear information about why only some pregnant women develop GTT. Previous papers stated that vitamin D plays a role in thyroid functions. We aimed to evaluate the relationship between vitamin D and GTT. MATERIALS AND METHODS: Fifty-three patients diagnosed with GTT at the 6th to 10th weeks of gestation were included in the study (GTT group)...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27933173/a-rare-case-of-gestational-thyrotoxicosis-as-a-cause-of-acute-myocardial-infarction
#7
Varalaxmi Bhavani Nannaka, Dmitry Lvovsky
: Angina pectoris in pregnancy is unusual and Prinzmetal's angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves' disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70-80 000 IU/L...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27930576/hyperthyroidism-secondary-to-hysterosalpingography-an-extremely-rare-complication-a-case-report
#8
Guotao Ma, Rui Mao, Haixin Zhai
RATIONALE: Hysterosalpingography (HSG), a standard procedure for the evaluation of women with infertility and repetitive pregnancy loss, is associated with complications such as uterine perforation, infection, allergic reactions, syncope, hemorrhage and shock, and pulmonary or retinal embolus. However, hyperthyroidism has not been reported as one of its complications. PATIENT CONCERNS AND DIAGNOSES: We report the case of a 33-year-old euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27919641/effect-of-hyperthyroidism-on-circulating-prolactin-and-hypothalamic-expression-of-tyrosine-hydroxylase-prolactin-signaling-cascade-members-and-estrogen-and-progesterone-receptors-during-late-pregnancy-and-lactation-in-the-rat
#9
Gisela E Pennacchio, Flavia J Neira, Marta Soaje, Graciela A Jahn, Susana R Valdez
Hyperthyroidism (HyperT) compromises pregnancy and lactation, hindering suckling-induced PRL release. We studied the effect of HyperT on hypothalamic mRNA (RT-qPCR) and protein (Western blot) expression of tyrosine hydroxylase (TH), PRL receptor (PRLR) and signaling pathway members, estrogen-α (ERα) and progesterone (PR) receptors on late pregnancy (days G19, 20 and 21) and early lactation (L2) in rats. HyperT advanced pre-partum PRL release, reduced circulating PRL on L2 and increased TH mRNA (G21 and L2), p-TH, PRLR mRNA, STAT5 protein (G19 and L2), PRLR protein (G21) and CIS protein (G19)...
December 2, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#10
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
#11
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/27843806/a-2016-italian-survey-about-the-clinical-use-of-selenium-in-thyroid-disease
#12
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/27824324/no-adverse-effects-after-radioiodine-treatment-at-3-weeks-of-pregnancy
#13
Matea Radacic-Aumiler, Iva Kraljickovic, Viktorija Edeljic-Turk, Ksenija Makar-Ausperger, Robert Likic, Iveta Simic
Radioactive iodine is used for the treatment of hyperthyroidism. Because it accumulates in the fetal thyroid, its administration during pregnancy may cause severe and potentially irreversible hypothyroidism in neonates, with consequent mental retardation, and it is contraindicated during the whole pregnancy. We present a case of a pregnant woman inadvertently treated with 1 mCi (37 MBq) of I in the earliest period of pregnancy and subsequently gave birth to a male infant without signs or symptoms of hypothyroidism or any other damage...
December 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27813690/fetal-neonatal-thyrotoxicosis-in-a-newborn-from-a-hypothyroid-woman-with-hashimoto-s-thyroiditis
#14
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
#15
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/27781488/current-challenges-in-the-pharmacological-management-of-thyroid-dysfunction-in-pregnancy
#16
I Khan, O E Okosieme, J H Lazarus
Thyroid dysfunction is common in pregnancy and has adverse fetal and maternal health consequences. A number of challenges in the management of gestational thyroid dysfunction remain unresolved including uncertainties in optimal thresholds for correction of hypothyroidism and strategies for pharmacological management of hyperthyroidism. Areas covered: We addressed key challenges and areas of uncertainty in the management of thyroid dysfunction in pregnancy. Expert commentary: Gestational thyroid hormone reference intervals vary according to population ethnicity, iodine nutrition, and assay method and each population should derive trimester specific reference intervals for use in pregnancy...
January 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27777478/clinical-and-radiological-correlations-in-patients-with-gestational-trophoblastic-disease
#17
REVIEW
Lana de Lourdes Aguiar Lima, Raphael Câmara Medeiros Parente, Izildinha Maestá, Joffre Amim Junior, Jorge Fonte de Rezende Filho, Carlos Antonio Barbosa Montenegro, Antônio Braga
Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase...
July 2016: Radiologia Brasileira
https://www.readbyqxmd.com/read/27766407/the-effects-of-gestational-transient-thyrotoxicosis-on-the-perinatal-outcomes-a-case-control-study
#18
Satoko Kinomoto-Kondo, Nagayoshi Umehara, Shiori Sato, Kohei Ogawa, Takeo Fujiwara, Naoko Arata, Haruhiko Sago
PURPOSE: To study the effects of gestational transient thyrotoxicosis (GTT) on pregnancy outcomes. METHODS: This case-control study retrospectively analyzed 7976 women with singleton pregnancies whose thyroid function was measured before 16 weeks of gestation and who delivered at ≥22 weeks of pregnancy. GTT was defined as hyperthyroidism (free thyroxine [FT4] level: ≥95th percentile) in the early pregnancy, which normalized in mid-pregnancy without thyroid-stimulating hormone receptor antibodies...
January 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27741549/management-of-hyperthyroidism-during-the-preconception-phase-pregnancy-and-the-postpartum-period
#19
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/27698567/managing-hyperthyroidism-in-pregnancy-current-perspectives
#20
Stine Linding Andersen, Peter Laurberg
Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain...
2016: International Journal of Women's Health
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