Prevalence of permanent hypothyroidism and its prognostic factors, 3 –5 years after postpartum thyroiditis
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F Sarvghadi , M Hedayati , Y Mehrabi , F Azizi |
, sarvghadi@erc.ac.iran.com |
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Abstract: (28147 Views) |
Introduction: Postpartum thyroiditis (PPT) is an autoimmune disorder that occurs during the first months after delivery in approximately 5-10 percent of women. Although it usually has a transient course, because of the autoimmune pathogenesis, long term follow up reveals permanent hypothyroidism in 20-30 percent of patients. In this survey, we tried to determine the prevalence of permanent hypothyroidism and its prognostic factors 3-5 years after PPT. Material and Methods : For this study, 1040 questionnaires from our previous study (Prevalence of PPT in Tehran 1998-1999) were reviewed and 54 women were invited 3-5 years after PPT as cases, and 50 healthy women were selected as controls. At the time of the visit, a questionnaire containing demographic information, signs and symptoms of thyroid disorders and physical examination was completed. Venous samples for T3, T4, T3RU (RIA), TSH (IMA) and anti-TPO and anti-Tg antibodies (ELISA) were obtained. Results: Twenty-two percent of cases and four percent of controls had permanent hypothyroidism (p< 0.01). Comparison of mean anti-TPO antibody titers between hypothyroid and euthyroid women in case group showed statistical significance (436.9±283 vs. 126.2±221 IU/mL, p<0.001), but not for anti-Tg antibody. The difference in mean peak postpartum TSH level between hypothyroid and euthyroid women in case group was significant (55.8±24 vs. 23.1±28 mU/L, p<0.001), and also for mean peak postpartum anti-TPO antibody titer (1959±1270 vs. 640±959I U/mL, p< 0.001). Conclusion: The result of this survey, like other studies, shows high prevalence of permanent hypothyroidism (22.2%) after PPT in Iran. High titer of anti-TPO antibody and TSH level during postpartum period are prognostic factors for occurrence of permanent hypothyroidism and we recommend long term follow up for women with PPT after recovery from thyroiditis. |
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Keywords: Postpartum thyroiditis, Hypothyroidism, Anti-TPO antibody, Anti-Tg antibody |
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Type of Study: Original |
Subject:
Endocrinology Received: 2006/11/23 | Published: 2004/06/15
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