Thyrotoxicosis during pregnancy can adversely influence
not only the mother but also the fetus. To avoid these influences,
it is essential to identify the underlying disease responsible
for thyrotoxicosis during pregnancy.
Thyrotoxicosis during the first trimester of pregnancy is
mostly attributable to Graves’ disease or gestational transient
hyperthyroidism [GTH, also called gestational transient thyrotoxicosis
(GTT)]. GTH is seen more frequently in Asians
than in other races. According to a report from Belgium, the
prevalence of Graves’ disease is about 0.2% while that of
GTH is 2% to 4% (1). Yeo et al reported that Graves’s disease
was seen in 1.2% and GTH in 11% of Singaporean
women in the first trimester of pregnancy (2). Graves’ disease
requires immediate treatment, while GTH can be
viewed as a physiological phenomenon that subsides spontaneously
without treatment in most of the cases.
Painless thyroiditis is a disease causing thyrotoxicosis
during the postpartum period or in other conditions. However,
according to our literature search, no cases of painless
thyroiditis developing during pregnancy have been reported,
and this disease is not generally considered in the differen tial diagnosis of thyrotoxicosis during pregnancy. Because
painless thyroiditis also subsides spontaneously, it is important
that this disease is distinguished from Graves’ disease.
We present herein a case of thyrotoxicosis detected during
the first trimester of pregnancy and diagnosed with painless
thyroiditis.
Thyrotoxicosis during pregnancy can adversely influencenot only the mother but also the fetus. To avoid these influences,it is essential to identify the underlying disease responsiblefor thyrotoxicosis during pregnancy.Thyrotoxicosis during the first trimester of pregnancy ismostly attributable to Graves’ disease or gestational transienthyperthyroidism [GTH, also called gestational transient thyrotoxicosis(GTT)]. GTH is seen more frequently in Asiansthan in other races. According to a report from Belgium, theprevalence of Graves’ disease is about 0.2% while that ofGTH is 2% to 4% (1). Yeo et al reported that Graves’s diseasewas seen in 1.2% and GTH in 11% of Singaporeanwomen in the first trimester of pregnancy (2). Graves’ diseaserequires immediate treatment, while GTH can beviewed as a physiological phenomenon that subsides spontaneouslywithout treatment in most of the cases.Painless thyroiditis is a disease causing thyrotoxicosisduring the postpartum period or in other conditions. However,according to our literature search, no cases of painlessthyroiditis developing during pregnancy have been reported,and this disease is not generally considered in the differen tial diagnosis of thyrotoxicosis during pregnancy. Becausepainless thyroiditis also subsides spontaneously, it is importantthat this disease is distinguished from Graves’ disease.We present herein a case of thyrotoxicosis detected duringthe first trimester of pregnancy and diagnosed with painless
thyroiditis.
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