Clinical Importance of Certain Immunological and Ultrasound Thyroid Characteristics for the Diagnosis of Postpartum Thyroiditis

Introduction: Postpartum thyroiditis (PPT) is an autoimmune disease associated with the presence of thyroid autoantibodies (TAAb) and changes in the morphological characteristics of the thyroid gland. Aim: To investigate the clinical importance of certain immunological and ultrasound thyroid characteristics for the diagnosis of postpartum thyroiditis. Patients and methods: 33 women with PPT and a control group of 53 euthyroid postpartum women were included in the study. Serum levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured and ultrasound evaluation of the size and morphology of the thyroid gland was performed during the postpartum period. Results: 72.7% of the patients with PPT were TAAb+ and in 69.7 % of the cases elevated levels of TPOAb were found. In the remaining 27.3 % postpartum thyroid dysfunction occured without immunological abnormalities. The majority of euthyroid women (92.5 %) did not have elevated TAAb. Different grades of thyroid hypoechogenicity were established in 91.9 % of the patients with PPT, while 24.5 % of the women without thyroid dysfunction had abnormal ultrasound findings. The thyroid volume of the women with PPT was significantly greater than that of the control group (p=0.000). Conclusion: TPOAb are the most significant immunological marker for the diagnosis of thyroid dysfunction during the postpartum period. However, TPOAb+ is not a universal finding among all women with PPT. The ultrasound parameters thyroid volume and hypoechogenicity play an important part in the comprehensive evaluation of patients with hormonal abnormalities during the postpartum period.