title: Lower incidence of postpartum thyrotoxicosis in women with Graves disease treated by radioiodine therapy than by subtotal thyroidectomy or with antithyroid drugs.
abstract: OBJECTIVE
  The incidence of postpartum thyrotoxicosis (PT) in Graves disease (GD) patients treated with antithyroid drugs (ATDs) is higher than in the general population, but the incidence of PT among GD patients who had been treated with radioiodine (RI) or by subtotal thyroidectomy before their pregnancy is not well known.
  
  
  METHODS
  We reviewed the cases of women with GD who had become pregnant, and we selected the 188 women who had undergone RI therapy before the pregnancy and the 148 women who had undergone subtotal thyroidectomy for GD before the pregnancy as the subjects of this study. The ATD subjects were 107 women with GD who had become pregnant after being treated with ATDs alone before their pregnancy and were in remission before and throughout the pregnancy.
  
  
  RESULTS
  The overall incidence of PT was 2.1% (4/188) in the RI group, 23.6% (35/148) in the subtotal thyroidectomy group, and 55.1% (59/107) in the ATD group. There were no cases of permanent thyrotoxicosis in the RI group.
  
  
  CONCLUSIONS
  The incidence of PT among women with GD who have undergone RI therapy before their pregnancy was significantly low compared to thyroidectomy group and ATD group. This finding is interesting because the incidence of PT in the RI group was lower than subtotal thyroidectomy group even though thyroid volume had been greatly reduced by thyroidectomy. RI treatment is recommended in the choice of treatment for childbearing-age women as regards the risk of postpartum recurrence.
authors.affiliation: From the Ito Hospital, Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Yoshihara
authors.forename: Jaeduk Yoshimura
authors.initials: JY
authors.lastname: Noh
authors.forename: Natsuko
authors.initials: N
authors.lastname: Watanabe
authors.forename: Kenji
authors.initials: K
authors.lastname: Iwaku
authors.forename: Sakiko
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Miho
authors.initials: M
authors.lastname: Suzuki
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ohye
authors.forename: Masako
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Yo
authors.initials: Y
authors.lastname: Kunii
authors.forename: Koji
authors.initials: K
authors.lastname: Mukasa
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000378:metabolism; D015994:Incidence; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D013965:Thyroidectomy; D013971:Thyrotoxicosis / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism
chemical_list: D013956:Antithyroid Agents; D018828:Immunoglobulins, Thyroid-Stimulating; D007457:Iodine Radioisotopes; C094372:thyrotropin-binding inhibitory immunoglobulin