propylthiouracil and Puerperal-Disorders

Topics: Abortion, Spontaneous; Adult; Antithyroid Agents; Autoantibodies; Diabetes Mellitus, Type 1; Diabetes, Gestational; Female; Fertilization in Vitro; Gestational Age; Graves Disease; Humans; Hyperthyroidism; Hypothyroidism; Infant, Newborn; Infertility, Female; Iodine; Male; Menstrual Cycle; Menstruation Disturbances; Pregnancy; Pregnancy Complications; Prevalence; Propylthiouracil; Puerperal Disorders; Risk Factors; Thyroid Diseases; Thyroid Gland; Thyroid Hormones; Thyroiditis; Thyrotropin; Thyroxine; Ultrasonography

Topics: Adult; Calcium; Carbimazole; Congenital Hypothyroidism; Dihydrotachysterol; Female; Humans; Hyperparathyroidism; Hyperthyroidism; Hypoparathyroidism; Hypothyroidism; Infant, Newborn; Parathyroid Diseases; Parathyroid Glands; Pregnancy; Pregnancy Complications; Propylthiouracil; Puerperal Disorders; Thyroid Diseases; Thyroxine

Thyrotoxicosis occurs more frequently during the post-partum period than at other times in women of childbearing age. Graves' disease and post-partum thyroiditis are two major causes of thyrotoxicosis in this period. The major task lies in differentiation of these two diseases in the post-partum period; since throtoxicosis caused by post-partum thyroiditis usually does not require treatment. The radioiodine uptake is elevated or normal in Graves' disease and low in post-partum thyroiditis, and TSH-receptor antibodies are positive in Graves' and negative in post-partum thyroiditis. Post-partum thyrotoxicosis due to Graves' disease may be treated with radioiodine but it requires radiation safety measurements for infant and is contraindicated if the mother is breast-feeding. Antithyroid drugs are the mainstay of the treatment of post-partum thyrotoxicosis. Recent investigations conclude that neither propylthiouracil nor methimazole cause any alterations in thyroid function and physical and mental development of infants breast-fed by lactating thyrotoxic mothers, and both can be safely administered in moderately high doses during lactation.

Topics: Antithyroid Agents; Breast Feeding; Female; Graves Disease; Humans; Infant, Newborn; Iodine Radioisotopes; Methimazole; Propylthiouracil; Puerperal Disorders; Radiotherapy; Thyroidectomy; Thyroiditis; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine

This case report describes the management of a breastfeeding mother who had been given radioactive iodine and technetium for diagnosis of thyroid disease. The mother requested to submit weekly milk samples for monitoring of radioactivity. Once activity fell below measurable counts, the mother resumed lactation.

Topics: Adult; Breast Feeding; Female; Humans; Hyperthyroidism; Infant; Iodine Radioisotopes; Metabolic Clearance Rate; Milk, Human; Propylthiouracil; Puerperal Disorders; Radiation Monitoring; Thyrotropin

Two Caucasian patients are described who had destructive postpartum thyroiditis (PPT) before the subsequent onset of Graves' hyperthyroidism (GH). HLA class II DQ typing in these two subjects identified putative susceptibility alleles previously detected in GH and PPT. Although PPT destructive thyroiditis preceding the development of GH is relatively uncommon, the occurrence of both these syndromes in the same patient suggests the possibility of an etiological role for thyroid antigen release and genetic susceptibility as pathogenic factors in the development of Graves' disease.

Topics: Abortion, Therapeutic; Adult; Female; Graves Disease; Humans; Iodine Radioisotopes; Middle Aged; Pregnancy; Propylthiouracil; Puerperal Disorders; Thyroiditis; Thyroxine

Topics: Alpha-Globulins; Female; Humans; Hyperthyroidism; Iodides; Pregnancy; Propylthiouracil; Puerperal Disorders; Thyroxine; Thyroxine-Binding Proteins

Hyperthyroidism is generally considered to be ameliorated during pregnancy, and there appears to be a high incidence of postpartum exacerbation. These phenomena have to our knowledge not been related to neonatal thyrotoxicosis, a transient hyperthyroidism seen only in newborns of previous or current hyperthyroid mothers. The first of two siblings of a previously thyrotoxic mother had marked symptoms of neonatal thyrotoxicosis and high levels of thyroid hormones. The mother had not received antithyroid treatment during her first pregnancy. During her next pregnancy she was treated with propylthiouracil from the second trimester. This infant had only minimal thyrotoxic signs but almost as high levels of thyroid hormones during the neonatal period as the elder. The mother had no signs of postpartum exacerbation but her thyroid hormones were significantly elevated in the postpartum period analogous to the infants. Neither the mother nor the infants presented any increase in thyroid-stimulation hormone and long-acting thyroid stimulator during the hyperthyroid periods. The possibility is discussed, that postpartum exacerbation of hyperthyroidism and neonatal thyrotoxicosis may be related. They could be the result of a changed balance between a thyroid stimulator and an inhibitor after birth.

Topics: Female; Humans; Hyperthyroidism; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Pregnancy; Propylthiouracil; Puerperal Disorders; Thyroxine; Triiodothyronine

Topics: Female; Humans; Obstetric Labor Complications; Pregnancy; Propylthiouracil; Puerperal Disorders; Thiouracil; Thyroid Gland; Thyrotoxicosis