Post-partum transient thyrotoxicosis: report of two cases

Area of Science:

• Endocrinology
• Immunology
• Reproductive Medicine

Background:

• Transient thyrotoxicosis can occur post-partum.
• Painless thyroiditis is a potential cause of thyrotoxicosis.
• Distinguishing causes of transient thyrotoxicosis is clinically important.

Observation:

• Two patients presented with post-partum transient thyrotoxicosis and painless thyroiditis.
• Low radioactive iodine uptake was noted in both cases.
• Surreptitious use of thyroid hormones or iodine was ruled out.

Findings:

• Patients exhibited a clinical course mimicking subacute thyroiditis (hyperthyroid, euthyroid, hypothyroid, recovery phases).
• Sustained elevation of anti-thyroglobulin antibody titers was observed throughout the disease.
• Thyroid biopsy in one case revealed chronic lymphocytic thyroiditis.
• The condition recurred after each pregnancy in both patients.

Implications:

• Pregnancy and delivery may trigger immunological changes contributing to this thyroid condition.
• Chronic lymphocytic thyroiditis may present with transient thyrotoxicosis in the post-partum period.
• Further research into the immunological interplay between pregnancy and thyroid autoimmunity is warranted.