Postpartum thyroiditis natural history, complications and prognosis: Difference between revisions
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*The symptoms of postpartum thyroiditis, PPT usually develop in the twevle months after devilry , abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows. | *The symptoms of postpartum thyroiditis, PPT usually develop in the twevle months after devilry , abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows. | ||
*There are three clinical courses: | *There are three clinical courses: | ||
*Classic triphasic: 25% of patients of PPT come to clinical attention with symptoms of hyperthyroidism followed by hypothyroidism and then euthyroidisum.<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | *Classic triphasic: 25% of patients of PPT come to clinical attention with symptoms of hyperthyroidism starting from sixth postpartum week followed by hypothyroidism around sixth postpartum month and then euthyroidisum by the of 12 months of postpartum .<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | ||
*Biphasic hyperthyroidism: 32 % patients of PPT develops symptoms of hyperthyroidism followed recovery.<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | *Biphasic hyperthyroidism: 32 % patients of PPT develops symptoms of hyperthyroidism followed recovery.<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | ||
*Biphasic hypothyroidism: 43 % patients of PPT develops symptoms of hypothyroidism followed recovery .<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | *Biphasic hypothyroidism: 43 % patients of PPT develops symptoms of hypothyroidism followed recovery .<ref name="pmid22312089">{{cite journal| author=Stagnaro-Green A| title=Approach to the patient with postpartum thyroiditis. | journal=J Clin Endocrinol Metab | year= 2012 | volume= 97 | issue= 2 | pages= 334-42 | pmid=22312089 | doi=10.1210/jc.2011-2576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22312089 }} </ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Prognosis is generally good, 25-30% in 3.5 to 8.7-year patients with postpartum thyroiditis PPT develop hypothyroidism.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of postpartum thyroiditis, PPT usually develop in the twevle months after devilry , abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows.
- There are three clinical courses:
- Classic triphasic: 25% of patients of PPT come to clinical attention with symptoms of hyperthyroidism starting from sixth postpartum week followed by hypothyroidism around sixth postpartum month and then euthyroidisum by the of 12 months of postpartum .[1]
- Biphasic hyperthyroidism: 32 % patients of PPT develops symptoms of hyperthyroidism followed recovery.[1]
- Biphasic hypothyroidism: 43 % patients of PPT develops symptoms of hypothyroidism followed recovery .[1]
- If left untreated, 25-30% of patients with PPT may progress to develop hypothyroidism[2]
- Patients who are anti-TPO antibodies positive,HLA-DRW9 and/or HLA-DRB51 [3] , and developed hypothyroid phase of PPT, are at increased risk of developing permanent hypothyroidism.[4]
Complications
- Common complications of include:
- Hypothyroidism
- Postpartum depression
Prognosis
- Prognosis is generally good, 25-30% in 3.5 to 8.7-year patients with postpartum thyroiditis PPT develop hypothyroidism.
References
- ↑ 1.0 1.1 1.2 Stagnaro-Green A (2012). "Approach to the patient with postpartum thyroiditis". J Clin Endocrinol Metab. 97 (2): 334–42. doi:10.1210/jc.2011-2576. PMID 22312089.
- ↑ Premawardhana LD, Parkes AB, Ammari F, John R, Darke C, Adams H; et al. (2000). "Postpartum thyroiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity". J Clin Endocrinol Metab. 85 (1): 71–5. doi:10.1210/jcem.85.1.6227. PMID 10634366.
- ↑ Tachi J, Amino N, Tamaki H, Aozasa M, Iwatani Y, Miyai K (1988). "Long term follow-up and HLA association in patients with postpartum hypothyroidism". J Clin Endocrinol Metab. 66 (3): 480–4. doi:10.1210/jcem-66-3-480. PMID 3162458.
- ↑ Stuckey, B G A; Kent, G N; Ward, L C; Brown, S J; Walsh, J P (2010). "ORIGINAL ARTICLE: Postpartum thyroid dysfunction and the long-term risk of hypothyroidism: results from a 12-year follow-up study of women with and without postpartum thyroid dysfunction". Clinical Endocrinology. 73 (3): 389–395. doi:10.1111/j.1365-2265.2010.03797.x. ISSN 0300-0664.