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Prevention and treatment of postpartum Graves' disease.
Lazarus, J H; Ludgate, M E.
Afiliación
  • Lazarus JH; Department of Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Baillieres Clin Endocrinol Metab ; 11(3): 549-60, 1997 Oct.
Article en En | MEDLINE | ID: mdl-9532339
Postpartum Graves' disease requires differentiation from postpartum thyroiditis and subacute thyroiditis in addition to other causes of hyperthyroidism. This may be done by assessing thyrotropin receptor antibody and radioiodine uptake together with clinical examination and thyroid scanning. The effect of pregnancy on thyroid function causes changes in iodine metabolism, thyroid hormone transport proteins and thyroid gland size. Amelioration of autoimmune disease such as Graves' disease, systemic lupus erythematosus and rheumatoid arthritis is often observed during pregnancy followed by postpartum exacerbation. The immunological effects of pregnancy involve placental factors as well as a transient diversion from T helper (Th) 1 to Th2 T-cell cytokine profile in addition to a change in B-cell lymphopoiesis. Prevention of postpartum Graves' disease by immune strategies which have been experimentally performed to reduce expression of diabetes in the non-obese diabetic mouse are attractive but not currently feasible in humans. Treatment of Graves' disease prior to pregnancy or postpartum with 131I is effective. Therapy with anti-thyroid drugs with or without thyroxine is variably effective.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Puerperales / Enfermedad de Graves Límite: Female / Humans / Pregnancy Idioma: En Revista: Baillieres Clin Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / METABOLISMO Año: 1997 Tipo del documento: Article Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Puerperales / Enfermedad de Graves Límite: Female / Humans / Pregnancy Idioma: En Revista: Baillieres Clin Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / METABOLISMO Año: 1997 Tipo del documento: Article Pais de publicación: Reino Unido