Roti E, Minelli R, Gardini E, Bianconi L, Neri T, Gavaruzzi G, Ugolotti G, Salvo D, Braverman L E
Centro per lo Studio, Prevenzione, Diagnosi e Cura delle Tireopatie, Universita di Parma, Italy.
J Clin Endocrinol Metab. 1991 Nov;73(5):958-63. doi: 10.1210/jcem-73-5-958.
Postpartum thyroiditis (PPT) is common and occurs in 1.7 to 16.7% of pregnant women, depending upon the study population. Most of these women develop transient hypothyroidism and thyroid function usually returns to normal. We have studied 11 euthyroid women with a previous history of PPT to determine the incidence of subtle defects in thyroid function measured by iodide-perchlorate (I-ClO4) discharge tests and TRH tests and to determine whether these women would develop iodide-induced hypothyroidism. Seven (64%) had positive I-ClO4 discharge tests and 5 (46%) had an abnormally high TSH response to TRH. Thyroid antimicrosomal and antithyroid peroxidase were positive in 8 women (73%) with a previous episode of PPT. The administration of pharmacological amounts of iodide (10 drops of saturated solution of potassium iodide daily) for 90 days to these 11 women resulted in elevated basal and TRH stimulated serum TSH concentrations in 8 (72.7%) compared to TSH values during iodide administration to women who had never been pregnant. Antimicrosomal and antithyroid peroxidase concentrations did not change during iodide administration. These findings strongly suggest that euthyroid women with a previous episode of PPT have permanent subtle defects in thyroid hormone synthesis and are inordinately prone to develop iodide-induced hypothyroidism, similar to findings previously reported in euthyroid subjects with Hashimoto's thyroiditis, with a previous episode of painful subacute thyroiditis, or previously treated with radioactive iodine or surgery for Graves' disease.
产后甲状腺炎（PPT）很常见，在1.7%至16.7%的孕妇中发生，具体比例取决于研究人群。这些女性中的大多数会出现短暂性甲状腺功能减退，甲状腺功能通常会恢复正常。我们研究了11名既往有产后甲状腺炎病史的甲状腺功能正常的女性，以确定通过碘 - 过氯酸盐（I - ClO4）释放试验和促甲状腺激素释放激素（TRH）试验测量的甲状腺功能细微缺陷的发生率，并确定这些女性是否会发生碘诱发的甲状腺功能减退。7名（64%）患者碘 - 过氯酸盐释放试验呈阳性，5名（46%）患者对TRH的促甲状腺激素（TSH）反应异常高。8名（73%）既往有产后甲状腺炎发作史的女性甲状腺微粒体抗体和抗甲状腺过氧化物酶呈阳性。给这11名女性服用药理剂量的碘（每日10滴碘化钾饱和溶液）90天，与从未怀孕的女性在服用碘期间的TSH值相比，8名（72.7%）患者的基础和TRH刺激的血清TSH浓度升高。在服用碘期间，微粒体抗体和抗甲状腺过氧化物酶浓度没有变化。这些发现强烈表明，既往有产后甲状腺炎发作史的甲状腺功能正常的女性在甲状腺激素合成方面存在永久性细微缺陷，并且极易发生碘诱发的甲状腺功能减退，这与先前在患有桥本甲状腺炎、既往有疼痛性亚急性甲状腺炎发作史、或先前接受过放射性碘治疗或因格雷夫斯病接受手术治疗的甲状腺功能正常的受试者中报道的结果相似。
