Research Article
Year 2020,
Volume: 42 Issue: 1, 94 - 99, 20.05.2020
Abstract
Supporting Institution
Destek alınmamıştır.
Project Number
yok
Thanks
yok
References
- 1. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev 2010; 31: 702-55.
- 2. Galofre JC, Davies TF. Autoimmune thyroid disease in pregnancy: a review. J Womens Health (Larchmt) 2009; 18: 1847-56.
- 3. Niebyl JR. Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med 2010; 16: 1544-50.
- 4. Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11: 527-39.
- 5. Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: A joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab 2005; 90: 586-7.
- 6. Grigoriu C, Cezar C, Grigoras M, Horhoianu I, Parau C, Vîrtej P, Lungu A, Horhoianu V, Poiana C. Management of hyperthyroidism in pregnancy. J Med Life 2008; 1: 390-6.
- 7. David S Cooper, Peter Laurberg. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol 2013; 1: 238-49.
- 8. Luewan S, Chakkabut P, Tongsong T. Outcomes of pregnancy complicated with hyperthyroidism:a cohort study. Arch Gynecol Obstet 2011; 283: 243-7.
- 9. Poppe K, Hubalewska-Dydejczyk A, Laurberg P, Negro R, Vermiglio F, Vaidya B. Management of Hyperthyroidism in Pregnancy: Results of a Survey among Members of the European Thyroid Association. Eur Thyroid J 2012 ;1: 34-40.
- 10. Alamdari S, Azizi F, Delshad H, Sarvghadi F, Amouzegar A, Mehran L. Management of hyperthyroidism in pregnancy: comparison of recommendations of american thyroid association and endocrine society. J Thyroid Res 2013; 2013: 878467.
- 11. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992; 167: 648-52.
- 12. Tan JY, Loh KC, Yeo GS, Chee YC. Transient hyperthyroidism of hyperemesis gravidarum. BJOG 2002; 109: 683-8.
- 13. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W; American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21:1081-125.
- 14. Laurberg P, Berman DC, Bülow Pedersen I, Andersen S, Carlé A. Incidence and clinical presentation of moderate to severe graves’ orbitopathy in a Danish population before and after iodine fortification of salt. J Clin Endocrinol Metab 2012; 97: 2325-32.
- 15. Matthews DC, Syed AA. The role of TSH receptor antibodies in the management of Graves’ disease. Eur J Intern Med 2011; 22: 213-6.
- 16. Park SY, Park SE, Jung SW, Jin HS, Park IB, Ahn SV, Lee S. Free triiodothyronine/free thyroxine ratio rather than thyrotropin is more associated with metabolic parameters in healthy euthyroid adult subjects. Clin Endocrinol (Oxf) 2017; 87: 87-96.
- 17. Yoshihara A, Noh JY, Mukasa K, Suzuki M, Ohye H, Matsumoto M, Kunii Y, Watanabe N, Suzuki N, Kameda T, Sugino K, Ito K. Serum human chorionic gonadotropin levels and thyroid hormone levels in gestational transient thyrotoxicosis: Is the serum hCG level useful for differentiating between active Graves' disease and GTT? Endocr J. 2015; 62: 557-60.
- 18. Tagami T, Hagiwara H, Kimura T, Usui T, Shimatsu A, Naruse M. The incidence of gestational hyperthyroidism and postpartum thyroiditis in treated patients with Graves’ disease. Thyroid 2007; 17: 767-72.
- 19. Laurberg P, Vestergaard H, Nielsen S, Christensen SE, Seefeldt T, Helleberg K, Pedersen KM. Sources of circulating 3,5,3´-triiodothyronine in hyperthyroidism estimated after blocking of type 1 and type 2 iodothyronine deiodinases. J Clin Endocrinol Metab 2007; 92: 2149-56.
- 20. Goldman AM, Mestman JH. Transient non-autoimmune hyperthyroidism of early pregnancy. J Thyroid Res 2011; 2011: 142413.
Year 2020,
Volume: 42 Issue: 1, 94 - 99, 20.05.2020
Abstract
Objective: The aim of this study was to evaluate free thyroid hormone index (FTHI) (FT3 index/ FT4 index) as a parameter to use in differential diagnosis of gestational Graves’ disease (GGD) and gestational transient thyrotoxicosis (GTT). GGD and GTT are the most common causes of thyrotoxicosis in early pregnancy and differential diagnosis is important since they are treated differently.
Method: Women who applied to our clinic with thyrotoxicosis were evaluated and 51 pregnant women were recruited to the study. Among the 51 women, 36 had GTT, 15 had GGD. The age, gestational age, thyroid stimulating hormone (TSH) levels, and FTHI (FT3 index / FT4 index) of all patients were recorded and compared. FT3/FT3 upper limit of normal (ULN) is referred as FT3 index. FT4 index is also referred as FT4/FT4 ULN. All diagnosis of GGD and GTT was confirmed with TRAb assays.
Results: The mean values of FT3, FT3 index, FTHI of the GGD group were found to be statistically significantly higher compared to GTT group (p: 0.002, p: 0.001, 0.001; respectively). No statistically significant difference was found between groups in terms of age, gestational age, FT4, FT4 index and TSH (p:0.999, p:0.730, p:0.620, p:0.570, p:0.291; respectively) FTHI values were above 1 in all patients with GGD while it was below 1 in GTT group.
Conclusions: The FTHI values above 1 may be used as a practical, cheap parameter for differential diagnosis between GGD and GTT.
Keywords
Gestational Graves’ disease gestational transient thyrotoxicosis free thyroid hormone index
Project Number
yok
References
- 1. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev 2010; 31: 702-55.
- 2. Galofre JC, Davies TF. Autoimmune thyroid disease in pregnancy: a review. J Womens Health (Larchmt) 2009; 18: 1847-56.
- 3. Niebyl JR. Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med 2010; 16: 1544-50.
- 4. Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11: 527-39.
- 5. Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: A joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab 2005; 90: 586-7.
- 6. Grigoriu C, Cezar C, Grigoras M, Horhoianu I, Parau C, Vîrtej P, Lungu A, Horhoianu V, Poiana C. Management of hyperthyroidism in pregnancy. J Med Life 2008; 1: 390-6.
- 7. David S Cooper, Peter Laurberg. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol 2013; 1: 238-49.
- 8. Luewan S, Chakkabut P, Tongsong T. Outcomes of pregnancy complicated with hyperthyroidism:a cohort study. Arch Gynecol Obstet 2011; 283: 243-7.
- 9. Poppe K, Hubalewska-Dydejczyk A, Laurberg P, Negro R, Vermiglio F, Vaidya B. Management of Hyperthyroidism in Pregnancy: Results of a Survey among Members of the European Thyroid Association. Eur Thyroid J 2012 ;1: 34-40.
- 10. Alamdari S, Azizi F, Delshad H, Sarvghadi F, Amouzegar A, Mehran L. Management of hyperthyroidism in pregnancy: comparison of recommendations of american thyroid association and endocrine society. J Thyroid Res 2013; 2013: 878467.
- 11. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992; 167: 648-52.
- 12. Tan JY, Loh KC, Yeo GS, Chee YC. Transient hyperthyroidism of hyperemesis gravidarum. BJOG 2002; 109: 683-8.
- 13. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W; American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21:1081-125.
- 14. Laurberg P, Berman DC, Bülow Pedersen I, Andersen S, Carlé A. Incidence and clinical presentation of moderate to severe graves’ orbitopathy in a Danish population before and after iodine fortification of salt. J Clin Endocrinol Metab 2012; 97: 2325-32.
- 15. Matthews DC, Syed AA. The role of TSH receptor antibodies in the management of Graves’ disease. Eur J Intern Med 2011; 22: 213-6.
- 16. Park SY, Park SE, Jung SW, Jin HS, Park IB, Ahn SV, Lee S. Free triiodothyronine/free thyroxine ratio rather than thyrotropin is more associated with metabolic parameters in healthy euthyroid adult subjects. Clin Endocrinol (Oxf) 2017; 87: 87-96.
- 17. Yoshihara A, Noh JY, Mukasa K, Suzuki M, Ohye H, Matsumoto M, Kunii Y, Watanabe N, Suzuki N, Kameda T, Sugino K, Ito K. Serum human chorionic gonadotropin levels and thyroid hormone levels in gestational transient thyrotoxicosis: Is the serum hCG level useful for differentiating between active Graves' disease and GTT? Endocr J. 2015; 62: 557-60.
- 18. Tagami T, Hagiwara H, Kimura T, Usui T, Shimatsu A, Naruse M. The incidence of gestational hyperthyroidism and postpartum thyroiditis in treated patients with Graves’ disease. Thyroid 2007; 17: 767-72.
- 19. Laurberg P, Vestergaard H, Nielsen S, Christensen SE, Seefeldt T, Helleberg K, Pedersen KM. Sources of circulating 3,5,3´-triiodothyronine in hyperthyroidism estimated after blocking of type 1 and type 2 iodothyronine deiodinases. J Clin Endocrinol Metab 2007; 92: 2149-56.
- 20. Goldman AM, Mestman JH. Transient non-autoimmune hyperthyroidism of early pregnancy. J Thyroid Res 2011; 2011: 142413.
There are 20 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Basic Science Research Articles |
| Authors | |
| Project Number | yok |
| Publication Date | May 20, 2020 |
| Acceptance Date | May 13, 2020 |
| Published in Issue | Year 2020Volume: 42 Issue: 1 |