Document Detail


The effect of pregnancy on subsequent relapse from Graves' disease after a successful course of antithyroid drug therapy.
MedLine Citation:
PMID:  18664537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pregnancy and the postpartum (PP) period are associated with profound changes of the immune system, which largely influence the clinical activity of autoimmune diseases. The aim of this study was to evaluate the effect of pregnancy and/or the PP period in driving a clinical relapse of hyperthyroidism in patients with Graves' disease (GD) who are in remission after antithyroid drug (ATD) treatment. Data were retrospectively collected from 150 female patients with GD, who were assigned to two groups according to the occurrence of a successful pregnancy after ATD withdrawal. RESULTS: Relapsing Graves' hyperthyroidism was observed in 70 of 125 patients in group I (no pregnancy after ATD withdrawal) (56.0%) and 21 of 25 patients in group II (pregnancy after ATD withdrawal) (84.0%) (P < 0.05). Logistic regression analysis (dependent variable: relapse/nonrelapse; covariates: age, positive family history for autoimmune thyroid disease, duration of treatment with ATD, number pregnancies at diagnosis, number of pregnancies after ATD withdrawal) showed a significant effect only for the number of pregnancies after ATD withdrawal [4.257 (1.315-13.782)]. The effect was ascribed to the PP period rather than to pregnancy itself because in 20 of 21 patients of group II (95.2%), the relapse of Graves' hyperthyroidism occurred between 4 and 8 months after delivery. CONCLUSIONS: The PP period is significantly associated with a relapse of hyperthyroidism in GD patients being in remission after ATD. We therefore recommend that patients with GD in remission after a course of ATD should have their thyroid function tested at 3 and 6 months after delivery.
Authors:
Mario Rotondi; Carlo Cappelli; Barbara Pirali; Ilenia Pirola; Flavia Magri; Rodolfo Fonte; Maurizio Castellano; Enrico Agabiti Rosei; Luca Chiovato
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-29
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  93     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-09     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3985-8     Citation Subset:  AIM; IM    
Affiliation:
Fondazione Salvatore Maugeri Istituto di Ricovero e Cura a Carattere Scientifico Chair of Endocrinology, University of Pavia, Via S. Maugeri 10, I-27100, Pavia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antithyroid Agents / therapeutic use*
Female
Follow-Up Studies
Graves Disease / diagnosis*,  drug therapy*,  epidemiology,  pathology
Humans
Postpartum Period / drug effects
Pregnancy / physiology*,  statistics & numerical data
Pregnancy Complications / diagnosis,  drug therapy,  epidemiology,  pathology
Prognosis
Recurrence
Remission Induction
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antithyroid Agents

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