PMID: 9532339Apr 9, 1998Paper

Prevention and treatment of postpartum Graves' disease

Baillière's Clinical Endocrinology and Metabolism
J H Lazarus, M E Ludgate

Abstract

Postpartum Graves' disease requires differentiation from postpartum thyroiditis and subacute thyroiditis in addition to other causes of hyperthyroidism. This may be done by assessing thyrotropin receptor antibody and radioiodine uptake together with clinical examination and thyroid scanning. The effect of pregnancy on thyroid function causes changes in iodine metabolism, thyroid hormone transport proteins and thyroid gland size. Amelioration of autoimmune disease such as Graves' disease, systemic lupus erythematosus and rheumatoid arthritis is often observed during pregnancy followed by postpartum exacerbation. The immunological effects of pregnancy involve placental factors as well as a transient diversion from T helper (Th) 1 to Th2 T-cell cytokine profile in addition to a change in B-cell lymphopoiesis. Prevention of postpartum Graves' disease by immune strategies which have been experimentally performed to reduce expression of diabetes in the non-obese diabetic mouse are attractive but not currently feasible in humans. Treatment of Graves' disease prior to pregnancy or postpartum with 131I is effective. Therapy with anti-thyroid drugs with or without thyroxine is variably effective.

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Citations

Dec 19, 2002·Thyroid : Official Journal of the American Thyroid Association·John H Lazarus
May 10, 2006·Journal of Endocrinological Investigation·F Azizi
Dec 24, 2005·Expert Opinion on Drug Safety·Fereidoun Azizi
Sep 6, 2000·Clinical Endocrinology·J H Lazarus, A Kokandi
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Aug 14, 1999·Thyroid : Official Journal of the American Thyroid Association·U S Masiukiewicz, G N Burrow
Jan 15, 2005·Treatments in Endocrinology·John H Lazarus
Sep 30, 2016·Journal of Pediatric Endocrinology & Metabolism : JPEM·Justyna Szczapa-JagustynJarosław Kocięcki
May 9, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Ece HarmanCandeger Yilmaz

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