Journal of Clinical Endocrinology & Metabolism, Vol 66, 480-484, Copyright © 1988 by Endocrine Society

ARTICLES

Long term follow-up and HLA association in patients with postpartum hypothyroidism

J Tachi, N Amino, H Tamaki, M Aozasa, Y Iwatani and K Miyai
Department of Laboratory Medicine, Osaka University Medical School, Japan.

The long term clinical outcome of postpartum hypothyroidism was investigated by follow-up studies of 44 patients (59 postpartum episodes; mean age of mothers at delivery, 28.2 yr) 5 or more yr later (mean interval after delivery, 8.7 yr; range, 5-16 yr). Forty-nine episodes (83%) in 34 women were followed by recovery within 1 yr postpartum, and those women remained euthyroid thereafter (group A); 10 women [10 episodes (17%)] developed permanent hypothyroidism during the follow-up period (group B). Five women in group B recovered during the first year, but became hypothyroid again later, the other 5 women in Group B remained persistently hypothyroid. HLA typing revealed significantly higher frequencies of HLA-DR3, -DRW8, -DRW9, -A26, -BW46, and -BW67, and significantly lower frequencies of HLA-DR2, -BW52, - BW62, and -CW7 in women with postpartum hypothyroidism than in normal women. Of 9 women with postpartum hypothyroidism who had HLA-DRW9 and/or -B51 associated with antithyroglobulin-antibody titers of 2(3) X 10 or higher, 6 developed permanent hypothyroidism. We conclude that long term follow-up is essential for women of postpartum hypothyroidism because of the risk of permanent hypothyroidism. The results suggest that some immunogenetic factors may be related to the etiology of postpartum hypothyroidism and that women with HLA-DRW9 and/or -B51 and higher titers of antithyroglobulin antibody are likely to develop permanent hypothyroidism.

This article has been cited by other articles:

				Subsection Reports J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s8 - s47. [Full Text] [PDF]

				M. Abalovich, N. Amino, L. A. Barbour, R. H. Cobin, L. J. De Groot, D. Glinoer, S. J. Mandel, and A. Stagnaro-Green Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., August 1, 2007; 92(8_suppl): s1 - s47. [Abstract] [Full Text] [PDF]

				F Azizi The occurrence of permanent thyroid failure in patients with subclinical postpartum thyroiditis Eur. J. Endocrinol., September 1, 2005; 153(3): 367 - 371. [Abstract] [Full Text] [PDF]

				A. Stagnaro-Green Postpartum Thyroiditis J. Clin. Endocrinol. Metab., September 1, 2002; 87(9): 4042 - 4047. [Full Text] [PDF]

				A. F. Muller, H. A. Drexhage, and A. Berghout Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care Endocr. Rev., October 1, 2001; 22(5): 605 - 630. [Abstract] [Full Text] [PDF]

				L. D. K. E. Premawardhana, A. B. Parkes, F. Ammari, R. John, C. Darke, H. Adams, and J. H. Lazarus Postpartum Thyroiditis and Long-Term Thyroid Status: Prognostic Influence of Thyroid Peroxidase Antibodies and Ultrasound Echogenicity J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 71 - 75. [Abstract] [Full Text]

				L. M. Crapo The Time Is Not Ripe To Screen J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 1816 - 1819. [Full Text]

				J. L. Kuijpens, M. de Haan-Meulman, H. L. Vader, V. J. Pop, W. M. Wiersinga, and H. A. Drexhage Cell-Mediated Immunity and Postpartum Thyroid Dysfunction: A Possibility for the Prediction of Disease? J. Clin. Endocrinol. Metab., June 1, 1998; 83(6): 1959 - 1966. [Abstract] [Full Text]

				C. M. Dayan and G. H. Daniels Chronic Autoimmune Thyroiditis N. Engl. J. Med., July 11, 1996; 335(2): 99 - 107. [Full Text] [PDF]