What Is Postpartum Thyroiditis?

Painless thyroiditis that occurs within one year after birth is also called postpartum thyroiditis. Painless thyroiditis is often accompanied by thyroid dysfunction. The incidence of postpartum thyroiditis is 5% to 10%. Although the etiology of postpartum thyroiditis is unclear, recent evidence suggests that it is an autoimmune disease of the thyroid gland.

Basic Information

English name: postpartum thyroiditis
Visiting department: Endocrinology

Common locations: thyroid
Common symptoms: Most patients are asymptomatic, and a few patients may have mild edema, fatigue, cold, etc.

Causes of postpartum thyroiditis

The cause is unclear and may be an autoimmune disease.

Clinical manifestations of postpartum thyroiditis

1. The course is similar to painless thyroiditis. Patients are usually asymptomatic, most of them are found during postpartum examination of thyroid function, and a few are found when patients have goiter or mild palpitations.

2. Most patients are asymptomatic. A few patients may have symptoms such as mild edema, fatigue, and cold during the hypothyroidism period. Many patients do not have throat discomfort. 10% to 20% of patients have local compression or thyroid pain. Occasionally mild tenderness.

3. The thyroid gland is bilaterally symmetrical and diffusely slightly enlarged. The isthmus and cone-shaped leaves often increase at the same time, but it can also be unilaterally enlarged. The thyroid gland often increases with the course of the disease, but it rarely compresses the neck. Difficulty breathing and swallowing. The thyroid has no adhesion to surrounding tissues during palpation and can move up and down during swallowing.

4. Neck lymph nodes are generally not swollen. A few cases may be accompanied by cervical lymph nodes swollen, but soft.

Postpartum thyroiditis examination

1. Serum thyroid microsomal antibody (TMAb) and thyroglobulin antibody (TGAb) are positive, and most of them show a slight increase.

2. Thyroid aspiration biopsy: Fine needle aspiration revealed a large number of lymphocytes and plasma cells.

3. The results of thyroid function tests are similar to those of painless thyroiditis. There are four periods: hyperthyroidism; normal hypothyroidism; hypothyroidism and normal hypothyroidism. Each period lasts about 1 to 3 months. Most patients cannot see four periods, and only one or two periods can be seen clinically.

Diagnosis of postpartum thyroiditis

Postpartum thyroiditis is often not easily diagnosed, and biopsy reveals lymphocyte infiltration like Hashimoto's thyroiditis, but without lymphoid follicles and fibers. Those with positive thyroid autothyroid antibodies during pregnancy are more likely to have postpartum thyroiditis. In postpartum thyroiditis, serum T ₃ and T ₄ levels increase during hyperthyroidism, and TSH is suppressed. At the same time, very low radioactive iodine intake is taken. These laboratory tests are similar to painless thyroiditis, because any radioactive examination and treatment are prohibited during lactation. Most patients cannot be tested for thyroid iodine uptake. Her white blood cell count and erythrocyte sedimentation rate were normal, without eye signs and pretibial myxedema.

Postpartum thyroiditis complications

Most patients returned to normal thyroid function, and a few patients had permanent hypothyroidism.

Postpartum thyroiditis treatment

Because postpartum thyroiditis is a self-limiting, transient disease that lasts only a few months; hyperthyroidism should be treated conservatively. Usually only -blockers, such as propranolol, can improve palpitations, tachycardia, and nervousness , Tremor, sweating, etc. Surgery and radiation therapy are contraindicated. Hypothyroidism may require thyroid hormone replacement therapy. Although some may be permanent hypothyroidism, most thyroid functions return to normal. Therefore, after 6 to 12 months postpartum, thyroid function must be re-evaluated and you should be pregnant again. Most of the disease will recur.