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Song, Han, Lee, Yang, Park, Kim, Han, Yoon, and Yim: A Case of Hypothyroidism in Remission during Pregnancy
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2012; 27(4): 295-298.

Published online: 20 December 2012

DOI: https://doi.org/10.3803/EnM.2012.27.4.295

A Case of Hypothyroidism in Remission during Pregnancy

Ha Do Song, Eun Jin Han, Sung Ja Lee, Ji Hoon Yang, So Young Park, Sung-Hoon Kim, Ki Ok Han, Hyun Koo Yoon, Chang Hoon Yim

Department of Internal Medicine, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.

Corresponding author: Chang Hoon Yim. Department of Internal Medicine, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, 17 Seoae-ro 1-gil, Jung-gu, Seoul 100-380, Korea. Tel: +82-2-2000-4719, Fax: +82-2-2264-1490, changhoon.yim@cgh.co.kr

Received 26 January 2012       Accepted 8 May 2012

Copyright © 2012 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hypothyroidism should be treated in pregnancy, because it has been associated with an increased risk of adverse pregnancy complications, as well as detrimental effects upon fetal neurocognitive development. The goal of L-thyroxine (LT4) treatment is to normalize maternal serum TSH values within the trimester-specific pregnancy reference range. 50% to 85% of hypothyroid women being treated with exogenous LT4 need to increase the dose during pregnancy. In this study, we report a case of a 29-year-old woman with hypothyroidism who had been in remission and discontinued LT4 treatment during her pregnancy. Three months after delivery she had a relapse of hypothyroidism and was retreated with LT4. Many factors can influence the gestational requirement for LT4, therefore maternal serum TSH should be monitored and the LT4 dose should be adjusted in pregnant patients with treated hypothyroidism.

Keywords: Hypothyroidism, Pregnancy, Spontaneous remission

Figures and Tables

Fig. 1
Serum free thyroxine (T4) and thyroid stimulating hormone binding inhibitory immunoglobulin (TBII) change during pregnancy and postpartum. The dosage of L-thyroxine (LT4) treatment is shown at the top. LT4 treatment was discontinued at 23 weeks of pregnancy, and restarted at 16 weeks after delivery.
enm-27-295-g001
Table 1
Thyroid function test and treatment during pregnancy and postpartum
enm-27-295-i001

LT4, L-thyroxine; T3, triiodothyronine; T4, thyroxine; TBII, TSH binding inhibitory immunoglobulin; TSH, thyroid stimulating hormone.

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