Recurrent Postpartum Thyroiditis in a Patient With Chronic Autoimmune Thyroiditis: A Case Report

Abstract

Postpartum thyroiditis is a destructive thyroiditis induced by an autoimmune mechanism that begins within the first few months after delivery. Postpartum thyroiditis can also occur after spontaneous abortion, here we report three documented episodes of recurrent postpartum thyroiditis, one of which developed after pregnancy loss. Our patient is a 33-year-old woman who complained of discomfort with palpitations two months after her first delivery. Laboratory examination of thyroid function tests (TFT) revealed transient hyperthyroidism followed by hypothyroidism and then recovery (a classic triphasic pattern). Two years later, the patient suffered a spontaneous abortion of her second pregnancy at 16 weeks gestation. Three months after the loss of this second pregnancy, TFT showed the classic triphasic pattern again. Two years following the spontaneous abortion, the patient gave birth to her second child, and three months after delivery, the patient complained of heat intolerance and irritability. Laboratory tests during this time showed an elevated FT4 and a low TSH. Tc-99m scintigraphy showed nonvisualization of both thyroid lobes, and 24-hour radioactive iodine uptake was 0.2%. This patient in this case presented with the classic triphasic pattern in all three episodes.