Postpartum thyroiditis 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.
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[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:
- Hypothyroidism
- Postpartum depression
- Recurrence
- Fetal mental retardation in future pregnancies in diagnosed cases.
- Overt hyperthyroid symptoms in future pregnancies.
Prognosis
- Prognosis is generally good, 25-30% in 3.5 to 8.7-year patients with postpartum thyroiditis PPT 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.