Subacute thyroiditis during pregnancy: clinical characteristics of seven cases.

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
European Thyroid Journal Pub Date : 2024-10-14 Print Date: 2024-10-01 DOI:10.1530/ETJ-24-0128
Hideyuki Imai, Natsuko Watanabe, Rei Hirose, Masakazu Koshibu, Masahiro Ichikawa, Akiko Sankoda, Shigenori Hiruma, Nami Suzuki, Masako Matsumoto, Miho Fukushita, Ai Yoshihara, Jaeduk Yoshimura Noh, Kiminori Sugino, Koichi Ito
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Abstract

Objective: There are few reports of subacute thyroiditis (SAT) during pregnancy. This study aimed to clarify the clinical characteristics of SAT in pregnant patients.

Methods and results: Seven patients diagnosed with SAT during pregnancy at our institution from January 2004 to December 2021 were identified, and their clinical findings were retrospectively examined. At SAT diagnosis, the median age was 34 (range: 31-42) years, the median duration of pregnancy was 5 (4-24) weeks, and all patients had neck pain but no fever. On laboratory examination, median (range) free thyroxine, free triiodothyronine, and C-reactive protein levels were 2.66 (1.14-7.77) ng/dL, 7.1 (3.3-16.1) pg/mL, and 2.22 (0.42-5.79) mg/dL, respectively, and all patients had a hypoechoic lesion of the thyroid gland. Three patients (43%) were treated with steroids, and three patients (43%) received replacement therapy with levothyroxine for hypothyroidism following destructive thyroiditis. There were no pregnancy complications in any of the cases. These seven patients (pregnancy group) were compared with 217 non-pregnant female patients (non-pregnancy group) aged 31 to 42 years who were diagnosed with SAT at our institution from 2016 to 2019. The frequency of body temperatures above 37°C was lower in the pregnancy group than in the non-pregnancy group (0% vs 65%).

Conclusion: Patients who develop SAT during pregnancy may have less fever than non-pregnant patients with SAT. There were no pregnancy complications in the pregnancy group in this study. This suggests that adverse pregnancy outcomes may be avoided by the appropriate management of SAT, including hypothyroidism after destructive thyroiditis.

妊娠期亚急性甲状腺炎:七例病例的临床特征。
目的:关于妊娠期亚急性甲状腺炎(SAT)的报道很少。本研究旨在阐明妊娠期亚急性甲状腺炎的临床特征:方法:研究人员对我院 2004 年 1 月至 2021 年 12 月期间确诊的 7 例妊娠期亚急性甲状腺炎患者的临床表现进行了回顾性研究。确诊 SAT 时,中位年龄为 34 [31-42]岁,中位孕期为 5 [4-24] 周,所有患者均有颈部疼痛,但无发热。实验室检查结果显示,游离甲状腺素、游离三碘甲状腺原氨酸和C反应蛋白水平的中位数(范围)分别为2.66(1.14-7.77)纳克/分升、7.1(3.3-16.1)皮克/毫升和2.22(0.42-5.79)毫克/分升,所有患者均有甲状腺低回声病变。3名患者(43%)接受了类固醇治疗,3名患者(43%)接受了左甲状腺素替代治疗,以治疗破坏性甲状腺炎引起的甲状腺功能减退症。所有病例均未出现妊娠并发症。这7名患者(妊娠组)与2016年至2019年在本院确诊为SAT的217名31至42岁非妊娠女性患者(非妊娠组)进行了比较。妊娠组患者体温超过37°C的频率低于非妊娠组(0%对65%):结论:与非妊娠期SAT患者相比,妊娠期SAT患者的发热可能较少。本研究中,妊娠组未出现妊娠并发症。这表明,通过对SAT(包括破坏性甲状腺炎后的甲状腺功能减退症)进行适当的治疗,可以避免不良的妊娠结局。
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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
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