Prevalence of Postpartum Onset of Disease within Patients with Graves' Disease of Child-Bearing Age.

Abstract

Abstract.To assess the prevalence of postpartum onset of disease among the patients with Graves' disease, we performed a retrospective examination of 289 consecutive female patients with Graves' disease who attended our thyroid clinic. Of these patients, 92 were female of child-bearing age (20-39 y.o.) who have had one or more deliveries, and at least 37 patients revealed clear evidences of postpartum onset of the disease. That is, at least 40% of Graves' patients of 20-39 y.o. developed their disease during the postpartum period.

Previous Live Births and Induced Abortions May Precede Later Development of Graves’ Hyperthyroidism

“…Several studies claimed that a major part of Graves’ patients are diagnosed within the post-partum period [10, 14, 27]. Most patients were diagnosed during the last half of the post-partum period, as there is a shift from Th1 to Th2 balance around 4–6 months after delivery, which is illustrated by rebound of B-cells peaking around 7–10 months after delivery [34, 35].…”

“…Age at menarche [11-13], age at menopause [12, 13], and the use of oral contraceptives (OC) [11, 12] have all been associated with altered risk for autoimmune diseases. A few studies examined the association between delivery and later development of Graves’ hyperthyroidism [5, 10, 14, 15], but no study has extensively investigated the long-term repercussions of multiple reproductive factors on the risk of developing various types of hyperthyroidism. We previously observed a strong association between the number of pregnancies and the later development of autoimmune hypothyroidism [16].…”

Case of Primary Biliary Cirrhosis-Autoimmune Hepatitis Overlap which Manifested after Delivery

“…B cells decrease at 1 month postpartum, but increase at 7-10 months postpartum. The postpartum increases in T and B cells are related to the postpartum onset or aggravation of autoimmune disease (1,(3)(4)(5)(6)(7)(8).…”

“…Onset of some diseases, including AIH and PBC, has been reported after parturition (3)(4)(5)(6)(7)(8)(9). PBC-AIH overlap is comparatively rare.…”

Pospartum autoimmune thyroid disorders

“…Так, в одном из исследований [20] среди 93 наблюдаемых жен щин детородного возраста с БГ у 31% из них бо лезнь манифестировала в послеродовом периоде. Tada H. et al (1994) в аналогичном исследовании выявили, что у 40% женщин БГ развилась в после родовом периоде. По данным более поздних иссле дований [7] БГ манифестирует после родов у 45% женщин.…”