ارزيابي اتوآنتي بادي هاي ضدپراكسيداز و ضد تيروگلبولين ، تظاهرات سونوگرافيك و تغييرات حجم تيروييد در افراد مبتلا به هيپوتريوييديسم دايم تا 5 سال بعد از ابتلا به تيروييديت پس از زايمان

Assessment of Antithyroglobulin and antiperoxidase autoantibodies, sonographic appearance and thyroid volume changes in women with permanent hypothyroidism, 5 years following postpartum thyroiditis

Introduction: Postpartum thyroiditis ( PPT) is an autoimmune disorder that occurs in 5-10 percent of women after delivery. Although it usually has a transient course , long term follow up reveals permanent hypothyroidism in up to 30% of patients; this is related to its autoimmune pathogenesis. In this survey we have tried to determine the prevalence of permanent hypothyroidism and its relation to antibody titer, and sonographic and thyroid volume changes 3-5 years after PPT. Materials and Methods: Based on the data of our previous survey " Prevalence of PPT in Tehran 1998-1999", 54 women 3-5 years after PPT (case group) and 50 healthy women (control group ), were enrolled. Initially a questionnaire containing demographic information, symptoms of thyroid diseases was completed and physical exams were carried out. Venous blood samples for T3,T4,T3RU, TSH, anti TPO and anti Tg antibodies were obtained, and eventually thyroid sonography was done. Results: Twenty-two percent of cases and four percent of the control group had hypothyroidism (p<0.01). Positive antibody titer in the case group was higher than in the control group (78%vs. 10% p<01001). Comparison between hypothyroid vs. euthyroid women in the case group for mean antiTPO Ab. was significant (437± 283 vs. 127+221 p<01001) and they also had more sonographic changes (78% vs. 18% p<01001). Mean thyroid volume in hypothyroids was 35% greater than among euthyroid women of the case group. Conclusion :Based on the results, a high prevalence of hypothyroidism 3-5 years after PPT was observed in Tehran. High percentage of positive antibodies reveals a subclinical autoimmune course in the case group and elevated titers of anti TPO Ab reveals an acute process in hypothyroid women; this is in agreement with sonographic changes. We recommend long term follow up of women with PPT for inflammatory permanent hypothyroidism.