ETA2023 Poster Presentations Pregnancy (9 abstracts)
Prevalence of postpartum worsening of graves’ orbitopathy in relation to thyroid dysfunction in patients with graves’ disease in japan
Nami Suzuki 1 , Natsuko Watanabe 1 , Noh Jaeduk Yoshimura 1 , Ai Yoshihara 1 , Miho Fukushita 1 , Masako Matsumoto 1 , Shigenori Hiruma 1 , Hideyuki Imal 1 , Kiminori Sugino 2 , Koichi Ito 3 , Ai Kozaki 4 & Tosyu Inoue 4
1Ito Hospital, Internal Medicine, Tokyo, Japan; 2Ito Hospital, Surgery, Tokyo, Japan; 3Ito Hospital, Ito Hospital, Surgery, Tokyo, Japan; 4Olympia Eye Hospital, Japan
Background: Graves’ hyperthyroidism is known to improve spontaneously during pregnancy due to immune tolerance, although postpartum worsening or relapse of hyperthyroidism is likely to occur.
Objective: To investigate the prevalence of postpartum worsening of Graves’ orbitopathy (GO) in relation to thyroid dysfunction.
Methods: This was a retrospective cross-sectional study that included 8594 patients with Graves’ disease (GD) with 12,322 live births, between January 2004 and August 2022. The patients in whom worsening of GO was suspected and were referred to ophthalmologists within 12 months after delivery were included in this study. Magnetic Resonence Imaging (MRI) was used for evaluating the activity of GO.
Results: A total of 75 patients were diagnosed with GO. The median age of the GO group was 32 (interquartile range 28-36) years, and the median time to worsening of GO was 7.0 (interquartile range 4.1-9.1) months. The values of TSH receptor (TSH-R) antibody and TSH-R stimulating antibody at the time of GO worsening were 9.0 IU/l and 1247%, respectively. Of the 75 patients, 65 developed postpartum exacerbation of thyroid dysfunction, 50 were not on medication, and 15 required antithyroid medication at delivery. In the postpartum thyroid dysfunction group, the median time to develop thyroid dysfunction was 6.3 months, though the median time to develop GO was 8.1 months. The detailed phases of GO were: active, 8 patients; recovery, 1 patient; inactive, 63 patients; and 3 patients who did not have MRI scans were not categorized. Eight patients in active phase received treatment for GO. Five patients received radiation therapy, and the remaining 3 patients received local steroid injection. Two of eight active GO patients were in the medication at delivery group, and the remaining 6 active GO patients were in the postpartum thyroid dysfunction group.
Conclusion: The prevalence of postpartum worsening of active phase GO was 0.064%. The results of the present study suggest that, active GO developed with postpartum thyroid dysfunction.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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