Silent Thyroiditis Presented as Transient Hypothyroidism during Pregnancy: A Case Report
Abstract
Silent thyroiditis during pregnancy is an under-recognized clinical condition and a rare case, often manifesting as transient hypothyroidism. We report a 23-year-old woman at 8 weeks of gestation who presented with newly diagnosed hypothyroidism [TSH = 85 mIU/L (0.4–4.5), FT4 = 0.4 ng/dL (0.7–2.5), and anti-TPO = 78 IU/mL (up
to 16)]. Thyroid function tests had been normal eight months prior. Levothyroxine (LT4) therapy was initiated, restoring euthyroidism. Treatment was discontinued postpartum, and the patient maintained normal thyroid function for over one year. Our case is unique in that silent thyroiditis occurred unusually early in pregnancy
and differed from the more common postpartum cases. Silent thyroiditis should be considered in pregnancy-related hypothyroidism, particularly when prior thyroid function was normal. Prompt diagnosis and treatment can prevent adverse maternal and fetal outcomes.
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Intern Med. 2012;51(5):475-7. https://doi.org/10.2169/internalmedicine.51.5742
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[13] Stagnaro-Green A, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Negro R. High rate of persistent hypothyroidism in a largescale prospective study of postpartum thyroiditis in southern Italy. J Clin Endocrinol Metab. 2011 Mar;96(3):652-7. https://doi.org/10.1210/jc.2010-1980
[14] Sheehan MT, Doi SA. Transient Hypothyroidism after Radioiodine for Graves’ Disease: Challenges in Interpreting
Thyroid Function Tests. Clin Med Res. 2016 Mar;14(1):40-5. https://doi.org/10.3121/cmr.2015.1297
[15] Balucan FS, Morshed SA, Davies TF. Thyroid autoantibodies in pregnancy: their role, regulation and clinical
relevance. J Thyroid Res. 2013;2013:182472. https://doi.org/10.1155/2013/182472
[16] Raposo L, Passos D. Tiroidites e gravidez [Thyroiditis and pregnancy]. Acta Med Port. 2003 Sep-Oct;16(5):343-5.
[17] Mallawa Kankanamalage O, Zhou Q, Li X. Understanding the Pathogenesis of Gestational Hypothyroidism. Front
Endocrinol (Lausanne). 2021 May 25;12:653407. https://doi.org/10.3389/fendo.2021.653407
[18] Iddah MA, Macharia BN. Autoimmune thyroid disorders. Int Sch Res Notices. 2013;2013:509764. https://doi.
org/10.1155/2013/509764
[2] Bogović Crnčić T, Girotto N, Ilić Tomaš M, Krištofić I, Klobučar S, Batičić L, Ćurko-Cofek B, et al. Innate Immunity in Autoimmune Thyroid Disease during Pregnancy. Int J Mol Sci. 2023 Oct 22;24(20):15442. https://doi.org/10.3390/ijms242015442
[3] Landek-Salgado MA, Gutenberg A, Lupi I, Kimura H, Mariotti S, Rose NR, et al. Pregnancy, postpartum autoimmune
thyroiditis, and autoimmune hypophysitis: intimate relationships. Autoimmun Rev. 2010 Jan;9(3):153-7. https://
doi.org/10.1016/j.autrev.2009.06.001
[4] van den Boogaard E, Vissenberg R, Land JA, van Wely M, van der Post JA, Goddijn M, et al. Significance of (sub)
clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update. 2011 Sep-Oct;17(5):605-19. https://doi.org/10.1093/humupd/dmr024
[5] Shinohara DR, Santos TDS, de Carvalho HC, Lopes LCB, Günther LSA, Aristides SMA, et al. Pregnancy Complications
Associated With Maternal Hypothyroidism: A Systematic Review. Obstet Gynecol Surv. 2018 Apr;73(4):219-230. https://
doi.org/10.1097/ogx.0000000000000547
[6] M. A. Kaykhaei,T. Mohammadi Fatideh,M. Sooghi.A case of subacute Thyroiditis in the first trimester of pregnancy[J].Acta endocrinologica: the international journal of the Romanian Society of Endocrinology,2012;8(1):125–130. https://doi.org/10.4183/aeb.2012.125
[7] Bai CF, Shen GH, Yang Y, Yang K, M RH, Zhou YY, et al. Subacute thyroiditis during early pregnancy: a case report and literature review. BMC Preg. Childbir. 2022;22(1):19. https://doi.org/10.1186/s12884-021-04368-2
[8] Nicholson WK, Robinson KA, Smallridge RC, Ladenson PW, Powe NR. Prevalence of postpartum thyroid dysfunction: a quantitative review. Thyroid. 2006 Jun;16(6):573-82. https://doi.org/10.1089/thy.2006.16.573
[9] Sato S, Endo K, Iizaka T, Saiki R, Iwaku K, Sato S, et al. A case of painless thyroiditis in a very early stage of pregnancy.
Intern Med. 2012;51(5):475-7. https://doi.org/10.2169/internalmedicine.51.5742
[10] Vaidya B, Chan S-Y. Thyroid Physiology and Thyroid Diseases in Pregnancy. In: Vitti P, Hegedüs L, editors. Thyroid Diseases: Pathogenesis, Diagnosis, and Treatment. Cham: Springer International Publishing; 2018. p. 673-708.
[11] Kamijo K, Saito T, Sato M, Yachi A, Mukai A, Fukusi M, et al. Transient subclinical hypothyroidism in early pregnancy.
Endocrinol Jpn. 1990 Jun;37(3):397-403. https://doi.org/10.1507/endocrj1954.37.397
[12] Shields BM, Knight BA, Hill AV, Hattersley AT, Vaidya B. Fiveyear follow-up for women with subclinical ypothyroidism in pregnancy. J Clin Endocrinol Metab. 2013 Dec;98(12):E1941-5. https://doi.org/10.1210/jc.2013-2768
[13] Stagnaro-Green A, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Negro R. High rate of persistent hypothyroidism in a largescale prospective study of postpartum thyroiditis in southern Italy. J Clin Endocrinol Metab. 2011 Mar;96(3):652-7. https://doi.org/10.1210/jc.2010-1980
[14] Sheehan MT, Doi SA. Transient Hypothyroidism after Radioiodine for Graves’ Disease: Challenges in Interpreting
Thyroid Function Tests. Clin Med Res. 2016 Mar;14(1):40-5. https://doi.org/10.3121/cmr.2015.1297
[15] Balucan FS, Morshed SA, Davies TF. Thyroid autoantibodies in pregnancy: their role, regulation and clinical
relevance. J Thyroid Res. 2013;2013:182472. https://doi.org/10.1155/2013/182472
[16] Raposo L, Passos D. Tiroidites e gravidez [Thyroiditis and pregnancy]. Acta Med Port. 2003 Sep-Oct;16(5):343-5.
[17] Mallawa Kankanamalage O, Zhou Q, Li X. Understanding the Pathogenesis of Gestational Hypothyroidism. Front
Endocrinol (Lausanne). 2021 May 25;12:653407. https://doi.org/10.3389/fendo.2021.653407
[18] Iddah MA, Macharia BN. Autoimmune thyroid disorders. Int Sch Res Notices. 2013;2013:509764. https://doi.
org/10.1155/2013/509764
| Files | ||
| Issue | Vol 9 No 5 (2024): September -October | |
| Section | Case Report(s) | |
| Keywords | ||
| Hypothyroidism Pregnancy Thyroiditis Transient Thyroid dysfunction | ||
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How to Cite
1.
Kaykhaei MA, Nosratzehi S. Silent Thyroiditis Presented as Transient Hypothyroidism during Pregnancy: A Case Report. CRCP. 2025;9(5):212-216.
