Postpartum thyroiditis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Prognosis is generally good, 25-30% in 3.5 to 8.7-year patients with [[postpartum thyroiditis]] PPT develop [[hypothyroidism]]. The symptoms of postpartum thyroiditis, PPT usually develop in the twelve months after delivery, abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows. Common complications of include hypothyroidism, postpartum depression, fetal mental retardation in future pregnancies in diagnosed cases and overt hyperthyroid symptoms in future pregnancies. | Prognosis is generally good, 25-30% in 3.5 to 8.7-year patients with [[postpartum thyroiditis]] PPT develop [[hypothyroidism]]. The symptoms of postpartum thyroiditis, PPT usually develop in the twelve months after delivery, abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows. Common complications of include hypothyroidism, postpartum depression, fetal mental retardation in future pregnancies in diagnosed cases and overt hyperthyroid symptoms in future pregnancies. Prognosis is generally good and 90% of patient recover to normal state after 12 months of postpartum. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
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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. The symptoms of postpartum thyroiditis, PPT usually develop in the twelve months after delivery, abortion or miscarriage of fetus and start with symptoms depending on clinical course that it follows. Common complications of include hypothyroidism, postpartum depression, fetal mental retardation in future pregnancies in diagnosed cases and overt hyperthyroid symptoms in future pregnancies. Prognosis is generally good and 90% of patient recover to normal state after 12 months of postpartum.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of postpartum thyroiditis, PPT usually develop in the twelve 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[1] followed by hypothyroidism around sixth postpartum month and then euthyroidisum by the of 12 months of postpartum .[2]
- Biphasic hyperthyroidism: 32 % patients of PPT develops symptoms of hyperthyroidism followed recovery.[2]
- Biphasic hypothyroidism: 43 % patients of PPT develops symptoms of hypothyroidism followed recovery .[2]
- If left untreated, 25-30% of patients with PPT may progress to develop hypothyroidism[3]
- Patients who are anti-TPO antibodies positive,HLA-DRW9 and/or HLA-DRB51 [4] , and developed hypothyroid phase of PPT, are at increased risk of developing permanent hypothyroidism.[5]
Complications
- Common complications of include:
Prognosis
- Prognosis is generally good and 90% of patient recover to normal state after 12 months of postpartum.[10]
- 25-30% in 3.5 to 8.7-year patients with postpartum thyroiditis develop hypothyroidism.
References
- ↑ Stagnaro-Green A (2000). "Recognizing, understanding, and treating postpartum thyroiditis". Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.
- ↑ 2.0 2.1 2.2 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.
- ↑ Stagnaro-Green A (2000). "Recognizing, understanding, and treating postpartum thyroiditis". Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.
- ↑ Stagnaro-Green A (2000). "Recognizing, understanding, and treating postpartum thyroiditis". Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.
- ↑ 8.0 8.1 Amino N, Mori H, Iwatani Y, Tanizawa O, Kawashima M, Tsuge I; et al. (1982). "High prevalence of transient post-partum thyrotoxicosis and hypothyroidism". N Engl J Med. 306 (14): 849–52. doi:10.1056/NEJM198204083061405. PMID 7062963.
- ↑ Hayslip CC, Fein HG, O'Donnell VM, Friedman DS, Klein TA, Smallridge RC (1988). "The value of serum antimicrosomal antibody testing in screening for symptomatic postpartum thyroid dysfunction". Am J Obstet Gynecol. 159 (1): 203–9. PMID 3394739.
- ↑ Alemu A, Terefe B, Abebe M, Biadgo B (2016). "Thyroid hormone dysfunction during pregnancy: A review". Int J Reprod Biomed (Yazd). 14 (11): 677–686. PMC 5153572. PMID 27981252.