Postpartum thyroiditis: an organ specific syndrome which is not associated with a postpartum polyclonal B-cell activation.
Recent reports have detailed the presence of autoantibodies characteristic of non-organ specific autoimmune diseases in the serum of patients with autoimmune postpartum thyroiditis (PPT). These observations suggest that PPT could be part of a polyclonal B-cell activation postpartum. We have measured 4 non-organ specific autoantibodies (anti-DNA, anti-cardiolipin, anti-nuclear factor (ANF) and antibodies against extractable nuclear antigens (ENA)) together with autoantibodies against thyroglobulin and thyroid peroxidase in a group of PPT women at 4 time points during the first year postpartum (early, time of hyperthyroidism, time of hypothyroidism, late). Whilst 18/18 patients showed thyroid specific autoantibody changes there was only a low frequency of occurrence of the non-organ specific autoantibodies (ENA 2/18; ANF 1/18; anti-DNA 2/18; anti-dsDNA 0/18; anti-cardiolipin 0/18) and, when positive, the response was poor. We conclude that PPT is not associated with a polyclonal b-cell activation but is a postpartum rebound of a thyroid specific autoimmune phenomenon.
Othman
S
S
Department of Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Amos
N
N
Parkes
A B
AB
Lazarus
J H
JH
Williams
B D
BD
Hall
R
R
D000974:Antibodies, Antinuclear / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis*; D002308:Cardiolipins / Q000276:immunology; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D011644:Puerperal Disorders / Q000276:immunology*; D013954:Thyroglobulin / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000276:immunology*
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D002308:Cardiolipins; D013954:Thyroglobulin; D007453:Iodide Peroxidase