(i)It is an autoimmune disorder
(ii)It is chracterised by lymphocyte infiltrate of thyroid gland
(iii)There is transient hyperthyroidism followed by hypothyroidism or one or other
(iv)It occurs in the first year of delivery.
The condition is more common on patients with family history of hypothyroidism, those with thyroid peroxidase antibodies and patients with type 1 DM.
3 phases of classical postpartum thyroiditis
1/3 of patients develop permanent hypothyroidism
presentation is usually between 3 to 4 months after delivery
(I)classical features of hyper or hypothyroidism is rarely observed
(II)painless enlargement of the gland
(I)thyroid function tests
(II)thyroid peroxidase antibodies.
(III) radioactive iodine uptake test may be necessary to differentiate from Graves' disease but this test can't be done in breast feeding mothers.
(*Thyroid receptor antibodies are present in Graves' disease)
Most patients recover spontaneously.
Treatment should be determined by symptoms rather than biochemistry.
hyperthyroid phase needs treatment beta blockers but not with antithyroid drugs.
hypothyroidism needs with treatment thyroxine. Only 3-4 % of women remain permanently hypothyroid.
(i)Post-partum thyroiditis – a clinical updateElio Roti and Ettore degli Uberti.European Journal of Endocrinology (2002) 146 275–279
(ii)Nelson-Piercy C. Handbook of obstetric medicine. Taylor & Francis; 2002.
(iii)Swiet MD. Medical disorders in obstetric practice. Wiley-Blackwell; 2002.