AUTOIMMUNE THYROID DISEASE AND PREGNANCY, WHAT COULD BE A COMMON FACTOR?
Keywords:
pregnancy, Graves’ disease, TRAb, autoimmune myxedema
Abstract
Autoimmune thyroid disease is more common in women than men, which is known to all physicians regardless of specialty. Currently is not uncommon for the diagnosis of a thyroid disease to be established following investigations performed as a preconception assessment or during the first weeks of pregnancy. It is important to note that pregnancy is accompanied by several adjustments both in terms of thyroid physiology and immune system, which may influence the evolution of an autoimmune thyroid disease in a pregnant woman. We want to emphasize their importance by presenting the case of a 26-year-old patient whose medical history, in terms of thyroid function, shifts from euthyroid to thyrotoxicosis and then to autoimmune myxedema over the course of two and a half years.
References
[1] E. K. Alexander et al., “2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum,” Thyroid, vol. 27, no. 3, pp. 315–389, Mar. 2017, doi: 10.1089/thy.2016.0457.
[2] J. C. Galofre and T. F. Davies, “Autoimmune Thyroid Disease in Pregnancy: A Review,” J Womens Health, vol. 18, no. 11, pp. 1847–1856, Nov. 2009, doi: 10.1089/jwh.2008.1234.
[3] “Hyperthyroidism In Pregnancy - StatPearls - NCBI Bookshelf.” https://www.ncbi.nlm.nih.gov/books/NBK559203/ (accessed Jan. 08, 2023).
[4] L. de Groot et al., “Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline,” J Clin Endocrinol Metab, vol. 97, no. 8, pp. 2543–2565, Aug. 2012, doi: 10.1210/jc.2011-2803.
[5] I. Bucci, C. Giuliani, and G. Napolitano, “Thyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance,” Front Endocrinol (Lausanne), vol. 8, Jun. 2017, doi: 10.3389/fendo.2017.00137.
[6] A. Gheorghisan-Galateanu, “Not Just Hashimoto’s Thyroiditis,” Acta Endocrinologica (Bucharest), vol. 15, no. 4, pp. 537–538, 2019, doi: 10.4183/aeb.2019.537.
[7] K. Michalek, S. A. Morshed, R. Latif, and T. F. Davies, “TSH receptor autoantibodies,” Autoimmun Rev, vol. 9, no. 2, pp. 113–116, Dec. 2009, doi: 10.1016/j.autrev.2009.03.012.
[8] G. Napolitano, I. Bucci, G. di Dalmazi, and C. Giuliani, “Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis,” Front Endocrinol (Lausanne), vol. 12, Nov. 2021, doi: 10.3389/fendo.2021.769084.
[9] J. Orgiazzi, “ANTI–TSH RECEPTOR ANTIBODIES IN CLINICAL PRACTICE,” Endocrinol Metab Clin North Am, vol. 29, no. 2, pp. 339–355, Jun. 2000, doi: 10.1016/S0889-8529(05)70135-3.
[10] A. Cocoloș et al., “RIEDEL’S THYROIDITIS: A RARE DIAGNOSIS THAT RARELY REQUIRES THYROID SURGERY,” Journal of Surgical Sciences, vol. 5, no. 1, pp. 38–41, 2018.
[11] P. P. LIMONE et al., “Graves’ orbitopathy: a multidisciplinary approach,” The Quarterly Journal of Nuclear Medicine and Molecular Imaging, vol. 65, no. 2, Apr. 2021, doi: 10.23736/S1824-4785.21.03350-1.
[12] S. Mbarek, F. Abid, W. Ammari, W. Alaya, A. Mahmoud, and R. Messaoud, “Graves’ Orbitopathy: Report of 82 cases.,” Tunis Med, vol. 99, no. 2, pp. 243–251, Feb. 2021.
[13] M. Jamshidian-Tehrani, A. Kasaei, Z. Mahdizad, M. A. Fard, and M. Aminizade, “Effect of Smoking on Retinal Thickness and Vascular Density in Thyroid Eye Disease,” Korean Journal of Ophthalmology, vol. 35, no. 5, pp. 376–382, Oct. 2021, doi: 10.3341/kjo.2021.0059.
[14] M. J. Schatz, B. C. McGeehan, M. G. Maguire, and C. A. Briceño, “Tobacco counseling in the setting of thyroid eye disease,” Arq Bras Oftalmol, vol. 85, no. 1, 2022, doi: 10.5935/0004-2749.20220003.
[15] J. Schovanek et al., “Adipocytokines in Graves’ orbitopathy and the effect of high-dose corticosteroids,” Adipocyte, vol. 10, no. 1, pp. 456–462, Jan. 2021, doi: 10.1080/21623945.2021.1980258.
[16] V. K. Patel, L. Padnick-Silver, S. D’Souza, R. K. Bhattacharya, M. Francis-Sedlak, and R. J. Holt, “Characteristics of Diabetic and Nondiabetic Patients With Thyroid Eye Disease in the United States: A Claims-Based Analysis,” Endocrine Practice, vol. 28, no. 2, pp. 159–164, Feb. 2022, doi: 10.1016/j.eprac.2021.11.080.
[17] J. Cao, Y. Su, Z. Chen, C. Ma, and W. Xiong, “The risk factors for Graves’ ophthalmopathy,” Graefe’s Archive for Clinical and Experimental Ophthalmology, vol. 260, no. 4, pp. 1043–1054, Apr. 2022, doi: 10.1007/s00417-021-05456-x.
[18] T.-Y. Hou, S.-B. Wu, H.-C. Kau, and C.-C. Tsai, “The Role of Oxidative Stress and Therapeutic Potential of Antioxidants in Graves’ Ophthalmopathy,” Biomedicines, vol. 9, no. 12, p. 1871, Dec. 2021, doi: 10.3390/biomedicines9121871.
[19] P. Cerri, B. Shahida, M. Lantz, and T. Planck, “Serum CYR61 Levels are Associated with Graves’ Ophthalmopathy and Smoking in Patients with Graves’ Disease,” Hormone and Metabolic Research, vol. 54, no. 03, pp. 168–174, Mar. 2022, doi: 10.1055/a-1743-2988.
[20] J. K. Aranyosi et al., “Different Effects of Cigarette Smoke, Heated Tobacco Product and E-Cigarette Vapour on Orbital Fibroblasts in Graves’ Orbitopathy; a Study by Real Time Cell Electronic Sensing,” Molecules, vol. 27, no. 9, p. 3001, May 2022, doi: 10.3390/molecules27093001.
[21] L. Bartalena et al., “The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy,” Eur J Endocrinol, vol. 185, no. 4, pp. G43–G67, Oct. 2021, doi: 10.1530/EJE-21-0479.
[2] J. C. Galofre and T. F. Davies, “Autoimmune Thyroid Disease in Pregnancy: A Review,” J Womens Health, vol. 18, no. 11, pp. 1847–1856, Nov. 2009, doi: 10.1089/jwh.2008.1234.
[3] “Hyperthyroidism In Pregnancy - StatPearls - NCBI Bookshelf.” https://www.ncbi.nlm.nih.gov/books/NBK559203/ (accessed Jan. 08, 2023).
[4] L. de Groot et al., “Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline,” J Clin Endocrinol Metab, vol. 97, no. 8, pp. 2543–2565, Aug. 2012, doi: 10.1210/jc.2011-2803.
[5] I. Bucci, C. Giuliani, and G. Napolitano, “Thyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance,” Front Endocrinol (Lausanne), vol. 8, Jun. 2017, doi: 10.3389/fendo.2017.00137.
[6] A. Gheorghisan-Galateanu, “Not Just Hashimoto’s Thyroiditis,” Acta Endocrinologica (Bucharest), vol. 15, no. 4, pp. 537–538, 2019, doi: 10.4183/aeb.2019.537.
[7] K. Michalek, S. A. Morshed, R. Latif, and T. F. Davies, “TSH receptor autoantibodies,” Autoimmun Rev, vol. 9, no. 2, pp. 113–116, Dec. 2009, doi: 10.1016/j.autrev.2009.03.012.
[8] G. Napolitano, I. Bucci, G. di Dalmazi, and C. Giuliani, “Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis,” Front Endocrinol (Lausanne), vol. 12, Nov. 2021, doi: 10.3389/fendo.2021.769084.
[9] J. Orgiazzi, “ANTI–TSH RECEPTOR ANTIBODIES IN CLINICAL PRACTICE,” Endocrinol Metab Clin North Am, vol. 29, no. 2, pp. 339–355, Jun. 2000, doi: 10.1016/S0889-8529(05)70135-3.
[10] A. Cocoloș et al., “RIEDEL’S THYROIDITIS: A RARE DIAGNOSIS THAT RARELY REQUIRES THYROID SURGERY,” Journal of Surgical Sciences, vol. 5, no. 1, pp. 38–41, 2018.
[11] P. P. LIMONE et al., “Graves’ orbitopathy: a multidisciplinary approach,” The Quarterly Journal of Nuclear Medicine and Molecular Imaging, vol. 65, no. 2, Apr. 2021, doi: 10.23736/S1824-4785.21.03350-1.
[12] S. Mbarek, F. Abid, W. Ammari, W. Alaya, A. Mahmoud, and R. Messaoud, “Graves’ Orbitopathy: Report of 82 cases.,” Tunis Med, vol. 99, no. 2, pp. 243–251, Feb. 2021.
[13] M. Jamshidian-Tehrani, A. Kasaei, Z. Mahdizad, M. A. Fard, and M. Aminizade, “Effect of Smoking on Retinal Thickness and Vascular Density in Thyroid Eye Disease,” Korean Journal of Ophthalmology, vol. 35, no. 5, pp. 376–382, Oct. 2021, doi: 10.3341/kjo.2021.0059.
[14] M. J. Schatz, B. C. McGeehan, M. G. Maguire, and C. A. Briceño, “Tobacco counseling in the setting of thyroid eye disease,” Arq Bras Oftalmol, vol. 85, no. 1, 2022, doi: 10.5935/0004-2749.20220003.
[15] J. Schovanek et al., “Adipocytokines in Graves’ orbitopathy and the effect of high-dose corticosteroids,” Adipocyte, vol. 10, no. 1, pp. 456–462, Jan. 2021, doi: 10.1080/21623945.2021.1980258.
[16] V. K. Patel, L. Padnick-Silver, S. D’Souza, R. K. Bhattacharya, M. Francis-Sedlak, and R. J. Holt, “Characteristics of Diabetic and Nondiabetic Patients With Thyroid Eye Disease in the United States: A Claims-Based Analysis,” Endocrine Practice, vol. 28, no. 2, pp. 159–164, Feb. 2022, doi: 10.1016/j.eprac.2021.11.080.
[17] J. Cao, Y. Su, Z. Chen, C. Ma, and W. Xiong, “The risk factors for Graves’ ophthalmopathy,” Graefe’s Archive for Clinical and Experimental Ophthalmology, vol. 260, no. 4, pp. 1043–1054, Apr. 2022, doi: 10.1007/s00417-021-05456-x.
[18] T.-Y. Hou, S.-B. Wu, H.-C. Kau, and C.-C. Tsai, “The Role of Oxidative Stress and Therapeutic Potential of Antioxidants in Graves’ Ophthalmopathy,” Biomedicines, vol. 9, no. 12, p. 1871, Dec. 2021, doi: 10.3390/biomedicines9121871.
[19] P. Cerri, B. Shahida, M. Lantz, and T. Planck, “Serum CYR61 Levels are Associated with Graves’ Ophthalmopathy and Smoking in Patients with Graves’ Disease,” Hormone and Metabolic Research, vol. 54, no. 03, pp. 168–174, Mar. 2022, doi: 10.1055/a-1743-2988.
[20] J. K. Aranyosi et al., “Different Effects of Cigarette Smoke, Heated Tobacco Product and E-Cigarette Vapour on Orbital Fibroblasts in Graves’ Orbitopathy; a Study by Real Time Cell Electronic Sensing,” Molecules, vol. 27, no. 9, p. 3001, May 2022, doi: 10.3390/molecules27093001.
[21] L. Bartalena et al., “The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy,” Eur J Endocrinol, vol. 185, no. 4, pp. G43–G67, Oct. 2021, doi: 10.1530/EJE-21-0479.
Published
2023-01-03
How to Cite
Dumitru, N., Panait, C., Cocoloș, A., Șandru, F., Valea, A., Carsote, M., & Ghemigian, A. (2023). AUTOIMMUNE THYROID DISEASE AND PREGNANCY, WHAT COULD BE A COMMON FACTOR?. Romanian Journal of Clinical Research, 5(2). Retrieved from https://rjcronline.com/index.php/rjcr/article/view/163
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