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Postpartum thyroiditis is believed to result from the modifications to the immune system necessary in pregnancy, and histologically is a subacute lymphocytic thyroiditis. The process is normally self-limiting, but when conventional antibodies are found there is a high chance of this proceeding to permanent hypothyroidism.
Subacute lymphocytic thyroiditis, also called painless or silent thyroiditis, occurs in individuals with underlying autoimmune disease or after pregnancy. [2] [4] [5] It is considered to be a variant of Hashimoto's thyroiditis. When subacute lymphocytic thyroiditis occurs up to 12 months postpartum, it is called postpartum thyroiditis.
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
Hypothyroidism is classified as either primary, secondary, or tertiary. Primary hypothyroidism is for when the cause is due to an abnormality of the thyroid gland, secondary hypothyroidism is when the cause is decreased thyroid-stimulating hormone levels, and tertiary hypothyroidism is when the cause is an inadequate amount of thyrotropin-releasing hormone being released.
In the US, hypothyroidism and hyperthyroidism were respectively found in 4.6 and 1.3% of the >12y old population (2002). [3] In some types, such as subacute thyroiditis or postpartum thyroiditis, symptoms may go away after a few months and laboratory tests may return to normal. [4] However most types of thyroid disease do not resolve on their own.
The recommendation is stronger in pregnant women with subclinical hypothyroidism (defined as TSH 2.5–10 mIU/L) who are anti-TPO positive, in view of the risk of overt hypothyroidism. If a decision is made not to treat, close monitoring of the thyroid function (every 4 weeks in the first 20 weeks of pregnancy) is recommended.
646.5 Asymptomatic bacteriuria in pregnancy; 646.6 Infections of genitourinary tract in pregnancy; 646.7 Liver disorders in pregnancy; 647 Infective and parasitic conditions in the mother classifiable 647.0 Syphilis complicating pregnancy childbirth or the puerperium; 647.1 Gonorrhea complicating pregnancy childbirth or the puerperium
De Quervain's thyroiditis, also known as subacute granulomatous thyroiditis or giant cell thyroiditis, is a self-limiting inflammatory illness of the thyroid gland. [1] De Quervain thyroiditis is characterized by fever , flu-like symptoms , a painful goiter , and neck pain .