Assessment of serum thyroid hormone autoantibodies in the first trimester of gestation as predictors of postpartum thyroiditis.

DM-1, type 1 diabetes mellitus FNAB, fine-needle aspiration biopsy FT3, free triiodothyronine FT4, free thyroxine GD, Graves’ disease HT, Hashimoto’s thyroiditis L-T4, Levothyroxine PH, permanent hypothyroidism PPT, Postpartum thyroiditis Postpartum Postpartum thyroiditis Pregnancy THAb, thyroid hormone autoantibodies TPOAb, thyroperoxidase autoantibodies TSH, thyrotropin Tg, thyroglobulin TgAb, thyroglobulin autoantibodies Thyroid autoimmunity Thyroid hormone autoantibodies US, ultrasound UST, ultrasonography signs suggestive of thyroiditis

Journal

Journal of clinical & translational endocrinology
ISSN: 2214-6237
Titre abrégé: J Clin Transl Endocrinol
Pays: Netherlands
ID NLM: 101629335

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 21 06 2019
revised: 22 07 2019
accepted: 22 07 2019
entrez: 21 8 2019
pubmed: 21 8 2019
medline: 21 8 2019
Statut: epublish

Résumé

Measurement of serum thyroperoxidase autoantibodies (TPOAb) during gestation as a classical marker for the risk of postpartum thyroiditis (PPT) predicts PPT in 1/3 to 1/2 of women. Very few studies have measured serum thyroid hormone Ab (THAb) during gestation, and none as a possible marker for PPT. In 412 women who were followed up from 7 to 11 weeks of gestation through 12 months after delivery, we measured THAb (T3.IgM, T3.IgG, T4.IgM, T4.IgG), thyroglobulin autoantibodies (TgAb) and TPOAb at study entry (7-11 week of gestation). Sixty-three women (15.3%) developed PPT, which progressed to permanent hypothyroidism (PH) in 34/63 (54%). THAb+ve were 21/412 women (5.1%), the frequency being greater in those who then developed PPT (12/63 [19.0%] vs Gestational positivity of THAb enhance enormously the predictivity for PPT of gestational positivity of TPOAb/TgAb. However, their low frequency (5.1%) and their sensitivity (17.5% [21/63]) go against their application in lieu of TPOAb/TgAb.

Sections du résumé

BACKGROUND BACKGROUND
Measurement of serum thyroperoxidase autoantibodies (TPOAb) during gestation as a classical marker for the risk of postpartum thyroiditis (PPT) predicts PPT in 1/3 to 1/2 of women. Very few studies have measured serum thyroid hormone Ab (THAb) during gestation, and none as a possible marker for PPT.
METHODS METHODS
In 412 women who were followed up from 7 to 11 weeks of gestation through 12 months after delivery, we measured THAb (T3.IgM, T3.IgG, T4.IgM, T4.IgG), thyroglobulin autoantibodies (TgAb) and TPOAb at study entry (7-11 week of gestation).
RESULTS RESULTS
Sixty-three women (15.3%) developed PPT, which progressed to permanent hypothyroidism (PH) in 34/63 (54%). THAb+ve were 21/412 women (5.1%), the frequency being greater in those who then developed PPT (12/63 [19.0%] vs
CONCLUSIONS CONCLUSIONS
Gestational positivity of THAb enhance enormously the predictivity for PPT of gestational positivity of TPOAb/TgAb. However, their low frequency (5.1%) and their sensitivity (17.5% [21/63]) go against their application in lieu of TPOAb/TgAb.

Identifiants

pubmed: 31428563
doi: 10.1016/j.jcte.2019.100201
pii: S2214-6237(19)30069-9
pii: 100201
pmc: PMC6693681
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100201

Références

J Clin Endocrinol Metab. 2000 Jan;85(1):71-5
pubmed: 10634366
Clin Endocrinol (Oxf). 2000 Jul;53(1):21-31
pubmed: 10931077
J Endocrinol Invest. 2002 Jan;25(1):32-8
pubmed: 11883864
J Endocrinol Invest. 2002 Dec;25(11):977-82
pubmed: 12553558
Thyroid. 2003 Oct;13(10):995-6; author reply 996
pubmed: 14611712
Clin Chem. 1991 Aug;37(8):1397-400
pubmed: 1868601
J Pediatr Endocrinol Metab. 2008 Oct;21(10):1011-20
pubmed: 19209623
J Endocrinol Invest. 2008 Dec;31(12):1063-8
pubmed: 19246971
J Clin Endocrinol Metab. 2011 Mar;96(3):652-7
pubmed: 21190974
J Clin Endocrinol Metab. 2012 Feb;97(2):334-42
pubmed: 22312089
Br J Dermatol. 2014 Oct;171(4):786-98
pubmed: 25059078
J Clin Endocrinol Metab. 2015 May;100(5):1870-8
pubmed: 25710564
Best Pract Res Clin Obstet Gynaecol. 2015 Jul;29(5):700-6
pubmed: 26028555
Ann Rheum Dis. 1989 Jun;48(6):496-501
pubmed: 2742403
Thyroid. 2016 Nov;26(11):1640-1644
pubmed: 27538922
Thyroid. 2017 Mar;27(3):315-389
pubmed: 28056690
Front Endocrinol (Lausanne). 2017 Aug 28;8:212
pubmed: 28894436
J Clin Transl Endocrinol. 2018 Nov 23;15:12-18
pubmed: 30555788
Clin Obstet Gynecol. 2019 Jun;62(2):359-364
pubmed: 30844908
Br Med J (Clin Res Ed). 1988 Jan 23;296(6617):241-4
pubmed: 3124900
Clin Chem. 1988 Dec;34(12):2561-2
pubmed: 3197301
Am J Clin Pathol. 1993 Sep;100(3):200-5
pubmed: 8379527
Eur J Endocrinol. 1996 Apr;134(4):449-53
pubmed: 8640296
J Clin Endocrinol Metab. 1997 Dec;82(12):4217-23
pubmed: 9398743

Auteurs

Salvatore Benvenga (S)

Department of Clinical and Experimental Medicine, University of Messina, Italy.
Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Italy.
Interdepartmental Program on Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, 98125 Messina, Italy.

Roberto Vita (R)

Department of Clinical and Experimental Medicine, University of Messina, Italy.

Flavia Di Bari (F)

Department of Clinical and Experimental Medicine, University of Messina, Italy.

Carmela Lo Re (C)

Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy.

Angela Scilipoti (A)

Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy.

Grazia Giorgianni (G)

Service of Immunometry and Laboratory Diagnosis, University Hospital G. Martino, 98125 Messina, Italy.

Loredana Grasso (L)

Service of Immunometry and Laboratory Diagnosis, University Hospital G. Martino, 98125 Messina, Italy.

Marina Raffaella Galletti (MR)

Department of Clinical and Experimental Medicine, University of Messina, Italy.

Mattia Grazia Mandolfino (MG)

Department of Clinical and Experimental Medicine, University of Messina, Italy.

Maria Le Donne (M)

Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy.
Department of Human Pathology Gaetano Barresi, University of Messina, Italy.

Classifications MeSH