ECE2018 Poster Presentations: Thyroid Thyroid (non-cancer) (105 abstracts)
Post partum and non-post partum relapsing Graves’ hyperthyroidism display different response to anti-thyroid drugs
Valentina Capelli 1, , Mario Rotondi 3 , Francesca Coperchini 3 , Sara Pinto 3 , Laura Croce 3 , Massimo Tonacchera 4 & Luca Chiovato 3
1Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; 2Department of Medical and Surgical Sciences, University of Pavia, Pavia, Italy; 3Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S., University of Pavia, Pavia, Italy; 4Endocrinology Section, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Pisa, Italy.
Background: Graves’ disease (GD) female patients in remission after a full course of methimazole (MMI) therapy are at risk for a relapse of hyperthyroidism during the post-partum (PP) period, but whether this relapse may display any peculiarity is still unknown.
Aim: To compare GD patients undergoing a relapse of hyperthyroidism either in the PP period or not.
Subjects and methods: Fourty-three female patients of childbearing age experiencing a relapse of GD hyperthyroidism were retrospectively evaluated. In 18 of them the relapse occurred in the PP period (i.e. within 12 months after delivery, PP group); in the remaining 25 the relapse occurred elsewhere during life (NPP group).
Results: At the time of the relapse, patients in the PP and NPP group were similar in terms of: age (34.4±6.0 years versus 36.9±5.7 years NS), thyroid volume (17.4±6.9 ml vs 17.4±6.1 ml, NS), thyroid function tests (FT3 7.64±4.05 pg/ml vs 8.07±3.67 pg/ml, NS) TRAb titers (4.37±2.95 U/l versus 7.25±7.22 U/l NS) and MMI starting dose (20.3±8.0 mg/day vs 20.6±9.01 mg/day, NS). However, the remission rate after a 12-month of MMI course was much greater (79%) in the PP as compared with the NPP (32%) group (P=0.002). Throughout the study span, a significant reduction in TRAb levels was observed in the PP (F=9.016; P=0.001), but not in the NPP group (F=2.433; NS). At 12 months the PP group also showed significantly lower mean TRAb levels (0.6±1.1 U/L vs 4.5±4.7 U/l, for PP and NPP, respectively; P=0.029).
Conclusions: Relapsing Graves’ hyperthyroidism in the PP period is more prone to undergo a remission of hyperthyroidism after a second course of MMI. A conservative therapeutic approach seems than to be more appropriate in GD patients experiencing a relapse of hyperthyroidism in the PP period.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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