Tiroiditis posparto. Revisión / Postpartum thyroiditis. A review

La tiroiditis posparto (TPP) es una disfunción tiroidea transitoria de etiología autoinmune que se presenta de forma típica en el primer año tras el parto en mujeres sin enfermedad tiroidea conocida antes del embarazo. Puede cursar con síntomas de tirotoxicosis seguida de hipotiroidismo y recuperación posterior de la función tiroidea, o como tirotoxicosis o hipotiroidismo aislados. Un gran porcentaje de las pacientes que presentan TPP reproducirán esta enfermedad tras los siguientes embarazos. Una gran proporción de mujeres desarrollará hipotiroidismo permanente durante los 3-10 años siguientes a un episodio de TPP. Es importante para el médico de familia estar familiarizado con esta enfermedad, por su gran prevalencia, y para un correcto diagnóstico e intervención terapéutica. Es fundamental también su papel en el seguimiento de estas pacientes, dadas las implicaciones negativas que el hipotiroidismo establecido tiene sobre la reproducción, en una población en edad genésica. En este artículo se revisan las características principales de la TPP, así como su abordaje diagnóstico y terapéutico (AU)

Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment (AU)

[Postpartum thyroiditis. A review]. / Tiroiditis posparto. Revisión.

Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment.

Plasma parathyroid hormone related-protein levels in patients with cancer, normocalcemic and hypercalcemic.

Hypercalcemia in patients with cancer may reflect the synthesis and secretion into circulation of parathyroid hormone-related protein (PTHrP) produced by the tumor. In the present study, we have measured circulating PTHrP concentrations in healthy subjects and patients using a new immunoradiometric assay (IRMA) that is specific for the 1-86 amino acid sequence of molecule, and in plasma collected with protease inhibitors. Plasma concentrations of PTHrP(1-86) were greater than the detection limit of the assay (0.3 pmol/l) in healthy subjects. All patients with hypercalcemia-associated cancer had PTHrP(1-86) levels significantly greater (median 7.74 pmol/l, P < 0.05) than healthy subjects or patients with cancer and normal serum calcium, primary hyperparathyroidism and hyperparathyroidism secondary to chronic renal failure. Plasma PTHrP and corrected serum calcium were correlated in patients with hypercalcemia-associated cancer. In one patient, a marked decrease in PTHrP and calcium levels was observed following surgery. Our results suggest that this IRMA for PTHrP(1-86) may be useful for diagnosis and monitoring of PTHrP-producing tumors induced hypercalcemia.

Automated quantification of TSH in serum by a chemiluminescent enzyme immunometric assay: analytical validation.

Thyroid stimulating hormone (thyrotropin; TSH) in serum was assayed with the Immulite-TSH, a fully automated solid-phase third-generation immunoassay analyzer that has a chemiluminescent detection system. The intraassay CV ranged from 3.6% to 6.2% for TSH mean concentrations from 0.025 to 32.12 mIU/L and the interassay CV ranged from 7.9% to 10% for TSH mean concentrations between 0.023 and 31.93 mIU/L. The analytical and functional detection limits of the assay were 0.001 and 0.0068 respectively. No interference was observed by any of the compounds: bilirubin, triglycerides, and hemoglobin. To compare the accuracy of Immulite-TSH with that of a conventional immuno-radiometric assay (Orion Diagnostica Irma-TSH), we examined 153 patient samples with TSH concentrations ranging approximately 0.2 to 100 mIU/L. At TSH concentration approximately 0.15 the precision was greater for Immulite-TSH than for Irma TSH (3.8% vs 11.87%) intraassay CV and (8.6% vs 35.4%) interassay CV. We concluded that Immulite-TSH is a rapid and precise third-generation assay, totally automated and the results can be provided to the clinician within 1 to 2 h of receipt of the patient's sample.

Serum insulin-like growth factor (IGF) binding protein-3 and IGF-I levels during childhood and adolescence. A cross-sectional study.

To investigate the effect of pubertal development on serum levels of IGF binding protein-3 (IGFBP-3) and IGF-I, and the relationship between IGFBP-3 levels and height, weight, weight for height and age (WFHA), and IGF-I levels, a cross-sectional study was performed in a Spanish basic education school in Vigo (NW Spain). The study was made up of 181 girls with a mean chronologic age of 11.03 +/- 0.22 y and 173 boys with a mean chronologic age of 10.9 +/- 0.23 y. The pubertal development was graded into three groups according to estradiol and testosterone concentrations for girls and boys, respectively. All subjects were in good health and among the 5th and 95th percentile for height. Serum IGFBP-3 and plasma IGF-I concentration was determined by RIA. Pubertal development was significantly associated with IGFBP-3 and IGF-I concentrations in girls and boys, respectively (p < 0.0001, analysis of variance). Multivariate regression analyses between IGF-I or IGFBP-3 with age, sex, and estradiol or testosterone show significative correlation in prepubertal children for IGF-I (r = 0.545, p = 0.0001 and r = 0.574, p = 0.0001 for girls and boys, respectively) and only in prepubertal boys for IGFBP-3 (r = 0.336, p = 0.0012). The linear correlation between IGF-I and IGFBP-3 was significant in both prepubertal (r = 0.25, p < 0.0001) and pubertal (r = 0.40, p < 0.0001) girls, but only in prepubertal boys (r = 0.30, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)