De novo clinical hypothyroidism in pregnancies complicated by type I diabetes, subclinical hypothyroidism, and proteinuria: a new syndrome.
Fifty-one women with type I diabetes who had normal thyroxine values before becoming pregnant were evaluated. Abnormalities of thyroid tests other than thyroxine were encountered in 26 women, of whom 8 developed a low serum thyroxine level, an elevated thyroid-stimulating hormone level, and a low insulin requirement in the second trimester subsequent to an increase in 24-hour urinary protein excretion to greater than 4 gm/24 hr. Thyroid replacement led to an increase in insulin requirement to levels appropriate for gestational age. It is concluded that the woman with type I diabetes who develops proteinuria greater than 4 gm/24 hr during gestation is at risk for the development of de novo hypothyroidism during pregnancy, evidenced by a low serum thyroxine level, an elevated thyroid-stimulating hormone level, and a drop in insulin requirement.
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications*; D007328:Insulin / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications; D011254:Pregnancy in Diabetics; D011507:Proteinuria / Q000150:complications* / Q000652:urine; D013577:Syndrome; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
D007328:Insulin; D013972:Thyrotropin; D013974:Thyroxine