Graves' Disease and the Post-partum Period: An Intriguing Relationship

The post-partum period is an immunologically peculiar period in a woman's life. Indeed, most of the pregnancy-related immune changes gradually revert in the 12 months following delivery. Although the post-partum period has long been identified as a period of aggravation of autoimmune thyroid diseases, most of the currently available studies took into account the relationship between post-partum and autoimmune thyroiditis. More recently, the potential repercussions of the post-partum period on Graves' disease were also taken into account. The present mini review will briefly overview the most recent advances in our knowledge of the immunology of the post-partum period in relation with the potential repercussions on the clinical course of Graves' disease. Moreover, some peculiar aspects of post-partum Graves' disease in terms of clinical and biochemical presentation, diagnostic challenges, and specific therapeutic considerations also taking into account the recommendation of the latest clinical guidelines on the management of thyroid diseases in pregnancy will be overviewed.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research

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The objective of the study was to assess the rate of recurrent pregnancy loss in patients with HT isolated or accompanied with non-endocrine autoimmune diseases. METHODS: This is a retrospective observational cohort study with systematic review of the NEAD with concurrent HT in an outpatient Endocrinology Unit at a University Hospital. Among the 3480 consecutively examined women with HT, 87 patients met the criteria of RPL and represented the study group. Sixty-five of them had isolated HT and 22 women had HT+NEAD. RESULTS: The rate of RPL in women with HT was 2.1% versus 5.64% observed in women with HT+NEAD (OR=2....
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
This article reviews the immunomodulatory role of vitamin D in autoimmune diseases and pregnancy. In particular, we will describe the role of vitamin D from conception until delivery, including the health of the offspring. This review highlights an observational study where hypovitaminosis D was correlated with decreased fertility, increased disease activity, placental insufficiency, and preeclampsia in women with APS.
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
This study raises the possibility of a role for surgery for patients with Hashimoto’s thyroiditis who continue to feel poorly despite optimal treatment with thyroid hormone. However, the study, while well done, is a relatively small one. We need longer-term follow up and confirmation with additional studies done on diverse populations. It’s also important to consider that thyroid surgery in patients with advanced Hashimoto’s thyroiditis is difficult. Rates of complications, including injury to the laryngeal nerve (which controls voice) and the parathyroid glands (which maintain normal blood calcium levels...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Thyroid Disorders Source Type: blogs
Thyroid dysfunction (TD) frequently occurs as an autoimmune complication of immune reconstitution therapy (IRT), especially in individuals with multiple sclerosis treated with alemtuzumab, a pan-lymphocyte depleting drug with subsequent recovery of immune cell numbers. Less frequently, TD is triggered by highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV), or patients undergoing bone-marrow/hematopoietic-stem-cell transplantation (BMT/HSCT). In both alemtuzumab-induced TD and HIV/HAART patients, the commonest disorder is Graves ’ disease (GD), followed by hypothyr...
Source: European Thyroid Journal - Category: Endocrinology Source Type: research
In this study, we reviewed major human studies on the health risks of radiation exposure and showed that sex-related factors may potentially influence the long-term response to radiation exposure. Available data suggest that long-term radiosensitivity in women is higher than that in men who receive a comparable dose of radiation. The report on the biological effects of ionizing radiation (BEIR VII) published in 2006 by the National Academy of Sciences, United States emphasized that women may be at significantly greater risk of suffering and dying from radiation-induced cancer than men exposed to the same dose of radiation....
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Maunil K. Desai1 and Roberta Diaz Brinton2,3* 1School of Pharmacy, University of Southern California, Los Angeles, CA, United States 2Center for Innovation in Brain Science, University of Arizona, Tucson, AZ, United States 3Departments of Pharmacology and Neurology, College of Medicine, University of Arizona, Tucson, AZ, United States Women have a higher incidence and prevalence of autoimmune diseases than men, and 85% or more patients of multiple autoimmune diseases are female. Women undergo sweeping endocrinological changes at least twice during their lifetime, puberty and menopause, with many women undergoin...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
This study is aimed at measuring the thyroxine requirement in hypothyroid patients with UC. Patients and Methods: Among 8,573 patients with thyroid disorders consecutively seen in our referral center from 2010 to 2017, we identified 34 patients with a definite diagnosis of UC. Thirteen of them were hypothyroid (12 F/1 M; median age = 53 years), bearing UC during the remission phase and in need for thyroxine treatment, thus representing the study group. The dose of T4 required by UC patients has been compared to the one observed in 51 similarly treated age- and weight-matched patients, compliant with treatment and clearly ...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
We report the case of a woman with autoimmune hypothyroidism and extremely high TRAb levels, with blocking and stimulating activities (biological activities characterized with Chinese hamster ovary cells expressing TSHR). At the 22-week point of her first gestation, sonography detected fetal growth retardation and cardiac abnormalities (extreme tachycardia, right ventricular dilatation, pericardial effusion). The mother's TRAb level, assayed later, was 4030 IU/L (N
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
Jie Cai1†, Yi Zhang1†, Yuying Wang1, Shengxian Li1, Lihua Wang1, Jun Zheng1, Yihong Jiang1, Ying Dong1, Huan Zhou1, Yaomin Hu1, Jing Ma1, Wei Liu1,2*† and Tao Tao1*† 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Pudong, China 2Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Pudong, China Background: Infertility and dyslipidemia are frequently present in both women...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Abstract Hashimoto's thyroiditis is one of the most common organspecific autoimune diseases and the most frequent cause of hypothyroidism in areas with sufficient iodine supply. Excessively stimulated T cells CD4+ and their differentiated cells are known to play a key role in the pathogenesis. It is currently accepted that on the one hand genetic susceptibility, environmental factors, existential factors (gender difference) play an important role, on the other hand gut and intestinal microbiota seem to contribute to its development too. Diagnosis requires a detailed medical history, sonography, and ...
Source: Nuklearmedizin - Category: Radiology Authors: Tags: Wien Med Wochenschr Source Type: research
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