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Cited by 114Thyroid Disorders and TreatmentsOphthalmology and Eye DisordersThyroid and Parathyroid Surgery

The Incidence of Gestational Hyperthyroidism and Postpartum Thyroiditis in Treated Patients with Graves' Disease

Tagami, Tetsuya, Hagiwara, Hanae, Kimura, Takashi, Usui, Takeshi, Shimatsu, Akira, Naruse, Mitsuhide·2007·Thyroid
DOI 10.1089/thy.2007.0003
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Abstract

Graves' disease (GD) is one of the most common thyroid diseases that cause hyperthyroidism. Gestational transient thyrotoxicosis (GTT) is nonautoimmune hyperthyroidism that occurs in women with a normal pregnancy. Postpartum transient thyroiditis (PTT) is a destructive thyroiditis induced by autoimmune mechanism in the postpartum period. Hyperthyroidism due to GD usually tends to improve during the course of gestation and exacerbate after delivery. When the patient with treated GD presents with thyrotoxicosis in the early pregnancy or in the postpartum period, differential diagnosis of exacerbation of GD with GTT or PTT is important because the latter disorders are fundamentally transient. To evaluate the incidence of GTT and PTT in a GD population, we investigated the thyroid functions, thyrotropin receptor antibodies (TRAb), and human chorionic gonadotropin (hCG) during pregnancy and for 1 year after delivery for 39 pregnancies in 34 women with GD. The incidence of GTT was 26% (10/39) of pregnancies. The peak value of hCG in the GTT group ([23.7 +/- 14.5] x 10(4) IU/mL, n = 9) was significantly higher than that in the non-GTT group ([13.3 +/- 4.7] x 10(4) IU/mL, n = 19). The incidence of PTT was 44% (17/39) of deliveries. The free triiodothyronine (FT(3))/free thyroxine (FT(4)) ratio of the exacerbation group of GD (3.1 +/- 1.0, n = 10) at the time of thyrotoxicosis after delivery was significantly higher than that of the PTT group (2.5 +/- 0.4, n = 16). The peak TRAb value of the exacerbation group of GD (72.5 +/- 121.7 IU/L, n = 10) at the time of thyrotoxicosis after delivery was also significantly higher than that of the PTT group (1.4 +/- 0.8 IU/L, n = 16). In conclusion, the high peak value of hCG is valuable for suspecting GTT, and the high FT(3)/FT(4) ratio is valuable for suspecting recurrence in the patients with GD. In both situations, changes of TRAb were also valuable in differentiating the recurrence of GD from GTT or PTT.

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Authors
Tagami, T., Hagiwara, H., Kimura, T., Usui, T., Shimatsu, A., & Naruse, M.
Affiliations
Kyoto Medical Center (JP)
ORCID
Venue
Thyroid
Publisher
SAGE Publications
Published
2007-08
Volume
17
Issue
8
Pages
767-772
ISSN
  • 1050-7256 (ISSN-L)
  • 1557-9077
DOI
10.1089/thy.2007.0003
OpenAlex
W2056162395
Cited by
114
References
23
Citations by year
2025: 3 · 2024: 2 · 2023: 6 · 2022: 5 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 59 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 1 · 2012: 6
FWCI
2.44
Type
journal article
Language
en
Open access
closed
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Thyroid (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
Graves' disease, postpartum thyroiditis, hyperthyroidism in pregnancy, TSH receptor antibodies, human chorionic gonadotropin, thyroid function, differential diagnosis, incidence, thyroid hormone replacement, antithyroid drugs
MeSH terms
Adult, Autoantibodies, Diagnosis, Differential, Female, Graves Disease, Humans, Pregnancy, Pregnancy Complications, Recurrence, Antithyroid Agents, Thyroid Function Tests, Thyroiditis, Thyrotoxicosis, Thyroxine, Triiodothyronine, Incidence, Prevalence, Postpartum Period

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