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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Thyroiditis occurs in the autoimmune conditions such as Hashimoto's thyroiditis and Graves' disease.127 Subacute thyroiditis is a transient thyrotoxic state and results in temporary hyperthyroidism, generally lasting a few weeks but sometimes persisting for months (Figure 10.45).128 Postpartum thyroiditis is a thyroid dysfunction that manifests within one year of pregnancy. Hyperthyroidism and toxic nodular goiter are more commonly seen in older women.129 An inflammatory component is commonly present in most if not all cancers, and thyroid cancer is no exception.130 There may be an increased risk of thyroid cancer among patients with Hashimoto's thyroiditis.131
Endocrinology
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Other causes of hyperthyroidism include: Toxic multinodular goitre: Nodules that secrete thyroid hormone, treated with radioiodine/surgery.Toxic adenoma: Solitary nodule producing thyroid hormone. Appears ‘hot’ on isotope scan. Treated with radioiodine.Ectopic thyroid tissue (e.g. from choriocarcinoma, ovarian teratoma).Exogenous thyroid (diet, excess levothyroxine).Subacute (de Quervain's) thyroiditis: Postviral hyperthyroidism with a painful goitre. Investigations show a raised ESR and low isotope uptake on scan. Treated with NSAIDs.Iatrogenic: Amiodarone, lithium.Postpartum thyroiditis: Occurs in 7% of women a year after giving birth.
Thyroid and parathyroid disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
If treatment of the hyperthyroid phase is required, this should be with β-blockers rather than with anti-thyroid drugs. Anti-thyroid drugs reduce thyroxine synthesis and the problem in postpartum thyroiditis is increased release, not synthesis.
Evaluating thyroid function in pregnant women
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
K. Aaron Geno, Robert D. Nerenz
The reemergence of preexisting Graves’ Disease in the postpartum period should be distinguished from postpartum thyroiditis (PPT), a de novo autoimmune condition experienced in the first year following delivery that affects approximately 5% of pregnant women in the general population [144]. Although the mechanisms of disease are different, both Graves’ Disease and PPT arise due to postpartum re-activation or re-aggravation of underlying autoimmune disease after a period of relative immunotolerance during pregnancy. Supporting this view is the observation that women with anti-TPO or anti-thyroglobulin (Tg) antibodies detected in the first trimester have a 33–50% chance of developing PPT, while the condition is rare in antibody-negative women. The classic presentation includes a brief thyrotoxic phase followed by hypothyroidism but only 20% of cases fit this description. Approximately 30% experience isolated thyrotoxicosis while the remaining 50% experience hypothyroidism only. Importantly, an estimated 30% of women who experience PPT go on to develop permanent primary hypothyroidism while the remainder return to a euthyroid state.
Two consecutive pregnancies in a patient with premature ovarian insufficiency in the course of classic galactosemia and a review of the literature
Published in Gynecological Endocrinology, 2022
Jagoda Kruszewska, Hanna Laudy-Wiaderny, Sandra Krzywdzinska, Monika Grymowicz, Roman Smolarczyk, Blazej Meczekalski
Six months later, the patient conceived without any medical intervention. The course of pregnancy was uneventful. Spontaneous labor occurred in the 40th week of gestation and a healthy boy, weighing 3500 g was born. Seven weeks later, the patient developed postpartum thyroiditis (TSH 0.003 UIU/m, fT4 1.61 pmol/L, fT3 4.17 pmol/L, FSH 94 mIU/mL, estradiol <10 pg/mL) and was treated with thiamazole at a dose of 3 × 15 mg until results normalization. Eight months after delivery, she conceived again, and again with a positive outcome, giving birth to a healthy girl weighing 3185 g. Throughout the second pregnancy, she was administered 25 μg thyroxine daily due to subclinical hypothyroidism. After both pregnancies she did not breastfeed the offspring. Afterwards, fertility issues were discussed and oral contraception was implemented (2 mg dienogest + 0.03 mg ethinylestradiol).
Secondary and tertiary preventions of thyroid disease
Published in Endocrine Research, 2018
Fereidoun Azizi, Ladan Mehran, Farhad Hosseinpanah, Hossein Delshad, Atieh Amouzegar
The prevalence of thyroid autoantibodies in women of childbearing age is 12 – 20%, but most of these women are euthyroid which whom 16% may develop a TSH that exceeds 4.0 mIU/L by the third trimester and 33–50% may develop postpartum thyroiditis.124 Previous studies report that the TPOAb positive rate for early pregnancy varies considerably and ranges from 5 to 17%.125 TPOAb positivity has been considered a risk factor for hypothyroidism, miscarriage, preterm delivery, perinatal death, postpartum thyroid dysfunction, and impaired motor and intellectual development in the offspring106,126,127 but this has not been confirmed by others.125,128 In a study by Stagnaro-Green and et al. in 1990, the miscarriage rate was doubled in euthyroid women with positive TPOAb compared with women who was TPOAb negative.129 A meta-analysis of evidence has shown that there is an association between thyroid autoantibodies and spontaneous miscarriage, as well as preterm birth.130 Miscarriage, or spontaneous pregnancy loss before the 24th week of gestation, is a common pregnancy complication affecting one in five pregnant women (17–33% gestations).131,132 Many factors like maternal age, family history, environmental exposure and maternal medical conditions may be attributed to the risk of spontaneous pregnancy loss. Preterm birth occurs in 6–15% of pregnancies and accounts for 75% of prenatal deaths, physical disabilities and adverse neurodevelopmental outcomes.133 Therefore, preterm delivery hence is accompanied by a high financial, psychological and social burden on the parents and community.134