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Biomedical subjects

C J Richards

Publications and source records attributed to C J Richards.

At least 19 recordsLinked to original sources
PubMed2000

Dietary carbohydrate source and energy intake influence the expression of pancreatic alpha-amylase in lambs.

In ruminants, pancreatic alpha-amylase is the primary enzyme responsible for the initial hydrolysis of alpha-linked glucose in the small intestinal lumen. The objective of this experiment was to examine the effects of altered dietary starch and energy supply on the expression of pancreatic alpha-amylase mRNA, protein and activity in lambs. Wether lambs (n = 24; 28 +/- 0.5 kg body weight) were fed low or high starch diets at 1.2 or 1.8 x net energy of maintenance for at least 28 d before tissue collection. Lambs fed the high energy/high starch diet tended to have more pancreatic alpha-amylase protein (54.5 kDa; P: = 0.08) and had greater activity (P: = 0.03), but alpha-amylase mRNA (1.6 kb) tended to be lower (P: = 0.17). Additionally, rumen fluid total short-chain fatty acid concentration was greater (P: = 0.04) and plasma glucose concentration tended to be greater (P: = 0.07) in lambs fed the high energy/high starch diet. However, pancreatic trypsinogen protein (25. 5 kDa) and jejunal maltase activity were not influenced by dietary treatment, suggesting that different regulatory systems are involved in regulating the tissue protein or activity levels of these two enzymes compared with alpha-amylase. These data suggest that dietary regulation of pancreatic alpha-amylase expression in ruminants is complex and probably regulated by transcriptional and post-transcriptional events.

Animals↗
PubMed2000

Efficacy of laidlomycin propionate in low-protein diets fed to growing beef steers: effects on steer performance and ruminal nitrogen metabolism.

We conducted two experiments to evaluate the effect of the ionophore laidlomycin propionate (LP) on steer performance and ruminal N metabolism. Experiment 1 was a 91-d growth study evaluating the growth and ruminal characteristics of steer calves consuming supplemental LP. Steers (n = 96; 255 +/- 3 kg; four steers/pen; six pens/treatment) were used in a randomized complete block design with a 2 x 2 factorial arrangement of treatments consisting of two levels of dietary CP (formulated to be 10.5 and 12.5% of DM) with and without LP (11 mg/kg diet DM). Ruminal fluid was collected via stomach tube on d 91 from one steer randomly selected from each pen. No CP x LP interactions were observed with performance data (P > .64). Final weight and total gain were greater (P < .07) for 12.5% CP and LP compared with 10.5% CP and control steers, respectively. Also, DMI was increased (P = .08) with 12.5% CP but not with LP supplementation (P = .36). In addition, ADG and gain:feed ratio were greater (P < .03) for both 12.5% CP and supplemental LP. Ruminal NH3 N concentration was greater (P < .09) with 12.5% CP and LP. Total VFA concentration and molar proportion of acetate were not affected by treatment (P > .11). However, propionate concentration was increased (P < .09) with 12.5% CP and LP, and acetate:propionate was lower (P = .02) with LP supplementation. In Exp. 2, six steers were used in a replicated 3 x 3 Latin square design to compare ruminal fermentation and protein degradation in steers without ionophore feeding or adapted to LP or monensin. In vitro deamination of amino acids by adapted ruminal microbes was also assessed. Ionophore supplementation decreased (P = .07) ruminal NH3 N concentration compared with control steers, and LP increased (P = .02) ruminal NH3 N compared with monensin. Molar proportion of acetate was decreased (P = .02) and propionate increased (P = .01) with ionophore treatment. Consequently, ionophore supplementation depressed the acetate:propionate ratio (P = .01). In situ degradation rate of soybean meal (SBM) CP was greater (P = .09) with ionophore treatment, but estimates of SBM undegradable intake protein were not altered by treatment (P > .25). Microbial specific activity of net NH3 N release and alpha-amino N degradation were decreased (P < .04) with ionophores. Based on this study, LP and monensin did not affect the extent of ruminal degradation of SBM CP but decreased amino acid deamination.

Animal Feed↗
PubMed1999

Rectal carcinoma: thin-section MR imaging for staging in 28 patients.

PURPOSE: To evaluate the accuracy of thin-section magnetic resonance (MR) imaging (in-plane resolution, 0.6 x 0.6 mm) in the preoperative assessment of the depth of extramural tumor infiltration, which is a major prognostic indicator in rectal cancer. MATERIALS AND METHODS: In a prospective study of 28 consecutive patients, preoperative MR imaging was performed. The tumor stage according to the TNM classification system and the measured depth of extramural tumor invasion in matched MR images and histopathologic slices were compared. RESULTS: Preoperative MR imaging correctly indicated the histopathologic tumor stage in all 25 patients in whom comparisons were possible. The difference between the depth of extramural tumor measured on preoperative MR images and corresponding measurements on histopathologic slices of the resection specimen ranged from -5.0 mm to +5.5 mm (mean difference, +0.13 mm; 95% CI: -2.72, +2.98 mm), indicating good agreement. The mesorectal fascia, and the relation of the tumor to it, could be visualized in every case. In all five patients with involvement of the circumferential excision margins of resection specimens, extensive extramural invasion was identified on preoperative MR images. CONCLUSION: Preoperative thin-section MR imaging accurately indicates the tumor stage of rectal cancer and depth of extramural tumor infiltration. It provides valuable information for identifying T3 tumors for preoperative adjuvant therapy in patients who are at high risk of failure of complete excision.

Female↗
PubMed1999

Net nutrient flux in visceral tissues of lambs fed diets differing in supplemental nitrogen source.

Eight multicatheterized wethers (35.9 +/- .8 kg BW) were used in a replicated 4 x 4 Latin square design to measure N retention and net uptake and release of plasma metabolites across the portal-drained viscera (PDV), hepatic (HEP), and total splanchnic (TS) tissues in response to changes in supplemental N source. Treatments selected to provide different amounts of undegradable intake protein (UIP) were urea, soybean meal (SBM), poultry by-product meal (PBM), and bloodmeal:corn gluten meal (BMCGM; 50:50 CP basis). Diets (urea, SBM, PBM, and BMCGM) contained 12.9, 13.8, 13.6, and 13.2% CP, respectively. Periods were 10 d, with total feces and urine collected on d 7 to 10 and blood sampled on d 10. Wethers were fed at 2% of BW in 12 daily portions. Nitrogen retention was 2.2, 3.3, 4.1, and 4.4 g/d for urea, SBM, PBM, and BMCGM, respectively. Urea had less (P < .01) N retention than SBM, PBM, and BMCGM; SBM had less N retention (P < .01) than PBM and BMCGM. Arterial, portal, and hepatic plasma flows were greater (P < .09) for SBM than for PBM and BMCGM (21 vs 16, 17; 84 vs 72, 72; 105 vs 87, 88 L/h). Portal plasma flow was greater (P < .10) for urea than for SBM, PBM, and BMCGM (85 vs 84, 72, 72 L/h). Portal-drained viscera and TS alpha-amino N (AAN) fluxes were less (P < .05) for PBM than for BMCGM (20.5 vs 26.6 and 7.2 vs 15.1 mmol/h), but TS AAN flux was less (P < .05) for urea than for SBM, PBM, and BMCGM (6.9 vs 16.9, 7.2, 15.1 mmol/h). Portal-drained viscera flux and HEP removal of NH3 N were greater (P < .001) for SBM than for PBM and BMCGM (27.7 vs 19.4, 20.6; -28.1 vs -20.0, -21.4 mmol/h). Gut use was less (P = .07) and HEP and TS fluxes of urea N were greater (P < .01) for SBM than for PBM and BMCGM (-4.92 vs -8.32, -7.93; 25.87 vs 16.54, 20.00; 20.95 vs 8.22, 12.07 mmol/h). These data suggest that PBM and BMCGM improved efficiency of N use compared with urea and SBM by reducing urinary N loss.

Animal Feed↗
PubMed1998

Effect of wet corn gluten feed, supplemental protein, and tallow on steer finishing performance.

Two trials evaluated the effects of level of wet corn gluten feed (WCGF), type of supplemental protein, and supplemental tallow on steer finishing performance. In Trial 1, WCGF was fed at 0, 25 (two diets), or 50% of the dietary DM replacing dry-rolled corn (DRC), molasses, and a portion of the supplement. The DRC control diet and one 25% WCGF diet were supplemented with a combination of protein sources. The second 25% WCGF diet was supplemented with urea alone. The 50% WCGF diet contained no additional protein supplementation. No differences in DMI (P > .10) were observed. Calves fed 25% WCGF plus a combination of protein sources or 50% WCGF gained faster (P < .10) and more efficiently (P < .10) than calves fed the DRC control. Calves fed 25% WCGF plus urea gained faster (P < .10) and tended (P = .14) to be more efficient than calves fed the DRC control. In Trial 2, WCGF was fed to replace 0 or 50% of the DRC and the molasses-urea supplement (DM basis). Both diets were fed with or without 3% tallow. Steers fed WCGF gained faster (P < .01) and more efficiently (P < .01) than steers fed DRC. Inclusion of 3% tallow increased gain (P < .05) and improved efficiency (P < .05). Feed efficiency is improved by the addition of WCGF or tallow to DRC finishing diets.

Animal Feed↗
PubMed1997

Considerations for gastrointestinal cannulations in ruminants.

The complexity of ruminant digestion necessitates a greater variety and complexity of experimental methods than with any other species. The fact that dietary ingredients are first subjected to microbial fermentation requires elaborate measures to ascertain nutrients presented for absorption. Numerous approaches have been attempted to obtain representative samples of digesta at sites throughout the gastrointestinal tract. The choices of a researcher before an experiment include animal(s), site(s) for cannula placement, style of cannula, cannula material, and numerous other more subtle factors that may contribute to the success of an experiment. This review compares the advantages and disadvantages of various approaches, cannula types, and cannula materials that should be considered before experiments are conducted.

Animals↗
PubMed1997

Clinical aspects of recurrent postpartum thyroiditis.

BACKGROUND: Postpartum thyroiditis (PPT), characterized by transient hyperthyroidism and transient hypothyroidism, occurs in 5-9% of women. It is accompanied by the presence of circulating antithyroid peroxidase antibodies (TPOAb) which have been associated with an increase in depressive symptomatology compared with TPOAb-negative women. AIM: To assess the frequency and nature of the syndrome in patients studied in detail after more than one pregnancy, as there are only sparse data on recurrence of PPT. METHOD: Fifty-four patients were identified who had participated in at least two of three detailed postpartum studies of thyroid and psychiatric function during the past 12 years in the Caerphilly and Cardiff regions of South Wales. They included two women who had had three pregnancies. All patients had been followed monthly postpartum for at least six months, and 44 had been followed for 12 months. RESULTS: Of the 13 patients who developed PPT after their first pregnancy, nine had a recurrence of dysfunction after a further pregnancy and four remained TPOAb positive. Of the 24 women who were euthyroid anti-TPO positive after the first pregnancy, six developed thyroid dysfunction after a subsequent delivery, 14 remained antibody positive and euthyroid, while four underwent seroconversion and were antibody negative. The control group of 17 women were antibody negative after the first pregnancy; 16 remained negative after a further pregnancy and one became anti-TPO positive. The severity of PPT was slightly, but not significantly worse after the second recorded pregnancy (67% hypothyroid versus 44% hypothyroid). Neither the maximum anti-TPO titre following the first pregnancy, nor the rise in titre during this period were predictive of outcome after a subsequent pregnancy. Data from 26 women showed that recurrent depression was seen in 15.4%; a further six were depressed after the first pregnancy only, and two during a further postpartum period. CONCLUSION: There was a 70% chance of developing recurrent PPT after a first attack, and a 25% risk even in women who were only anti-TPO positive without thyroid dysfunction during the first postpartum period. The recurrence of postpartum depression was not related to thyroid function. Patients noted to have thyroid dysfunction or just to be euthyroid but anti-TPO positive after pregnancy should be assessed carefully after a subsequent pregnancy.

Autoantibodies↗
PubMed1996

The clinical spectrum of postpartum thyroid disease.

The clinical and biochemical features of postpartum thyroid disease were analysed in 152 antithyroid peroxidase antibody-positive (anti-TPO+ve) women and compared with 239 anti-TPO-ve age-matched control postpartum women. All were assessed monthly for up to 12 months postpartum. Seventy three anti-TPO+ve women developed postpartum thyroiditis (PPT): 19.2% hyperthyroid alone, 49.3% hypothyroid alone, and 31.5% characterized by hyper- followed by hypothyroidism. None of the antibody-negative women developed any thyroid dysfunction. A significant increase in many of eleven symptoms of hypothyroidism and some of eight symptoms of hyperthyroidism compared to control women was observed in all anti-TPO+ve women, independent of thyroid status. This was particularly seen in women who later developed PPT when they were euthyroid, but was also observed in euthyroid anti-TPO+ve women who showed no decline of thyroid function during the postpartum period. Although PPT is usually transient, this condition, and the euthyroid antibody-positive state, may be associated with significant symptomatology, including an increased incidence of minor to moderate depression. Early recognition of this syndrome by antenatal screening of thyroid antibodies may contribute to improved management of women during the postpartum period.

Adult↗
PubMed1996

Major histocompatibility complex class II and complement polymorphisms in postpartum thyroiditis.

The objective was to re-evaluate the association between class II HLA-DR and DQ MIIC antigens and postpartum thyroiditis (PPT) and to determine the prevalence of the class III complement allotypes of Properdin factor B (Bf), C4A and C4B in this condition. Two hundred and sixty-five (of 2897) pregnant women screened positive for thyroid autoantibody activity took part. Further blood samples were obtained for HLA class II (185) and complement (193) typing. The severity of the ensuing PPT was assessed by measuring thyroid function during the postpartum year. The HLA-DR and DQ phenotypes were assigned from restriction fragment length polymorphism analysis, and Bf, C4A and C4B allotypes were determined by immunofixation with anti-Bf or anti-C4 antibodies after electrophoresis. A weak association between the HLA class II antigens and PPT, as indicated by a reduced frequency of DR15 and DQ6 together with an increased frequency of-DR5 and DQ7, was confirmed. However, only the change in DR5 frequency remained significant after correction (corrected p < 0.05). Postpartum thyroiditis was also associated with frequency disturbances in BI and C4A allotypes but not C4B allotypes. Whilst this study has not provided evidence of a strong marker gene for PPT, it does not preclude the involvement of the MIIC in this condition. These data show disturbances in complement allotype frequencies, suggesting that the class III region may provide a useful focus for further study of this pathology.

Complement C4a↗
PubMed1995

Effect of level and type of fat on subacute acidosis in cattle fed dry-rolled corn finishing diets.

Five experiments were conducted to determine the effect of fat addition to dry-rolled corn (DRC) finishing diets on subacute acidosis. In Exp. 1, five ruminally fistulated steers (410 +/- 12 kg BW) were used in a 5 x 5 Latin square design. Treatments consisted of 0, 2, 4, 6, or 8% tallow added to a 50% fine-ground corn: 50% dry-rolled wheat basal challenge diet and dosed intraruminally as an acidosis challenge. Area below pH 6 was determined to quantify the total decrease in ruminal pH over a 24-h period. Area below pH 6 responded quadratically (P < .05); greatest time below pH 6 occurred with diets containing 2, 4, and 6% tallow. In Exp. 2, six ruminally fistulated steers (527 +/- 47 kg BW) were used in a 6 x 6 Latin square design and intraruminally dosed with 0, 4, 6, or 8% tallow or 4 or 8% yellow grease added to a 50% fine-ground corn:50% dry-rolled wheat basal challenge diet. Area below pH 6 responded quadratically for both tallow (P = .10) and yellow grease (P < .05) and was greatest for steers dosed with 4% tallow or yellow grease and decreased as tallow or yellow grease increased from 4 to 8%. Experiment 3 was a metabolism study using six ruminally fistulated steers (469 +/- 68 kg BW) in a 6 x 6 Latin square design. Cattle were fed a DRC finishing diet containing 0, 4, 6, or 8% tallow or 4 or 8% yellow grease.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗
PubMed1994

The iodide perchlorate discharge test in women with previous post-partum thyroiditis: relationship to sonographic appearance and thyroid function.

BACKGROUND: Post-partum thyroid disease occurs in 50% of anti-thyroid peroxidase (TPO) antibody positive women (detected at 16 weeks' gestation) and is characterized by a transient episode of hyper, hypo or hyper-hypothyroidism. In approximately 20% of these women the hypothyroidism is permanent. However, the extent of long-term thyroid dysfunction, possibly mediated by immune attack, in those anti-TPO Ab + ve women who have had only transient or no thyroid dysfunction during the postpartum period is not clear. OBJECTIVE: We have therefore studied the frequency of iodide organification defects by iodide perchlorate discharge testing, and of thyroid morphological abnormalities by ultrasound scanning in euthyroid women following their episode of post-partum thyroiditis (PPT). DESIGN: The study group comprised 17 women with previous PPT (PPT + ve) and 12 women who had positive anti-TPO antibodies during pregnancy but who did not develop PPT (PPT - ve). Women were studied 15-47 months following their episode of PPT. RESULTS: Iodide perchlorate discharge tests were positive (more than 10% discharge) in 7 (41%) PPT + ve and 5 (42%) PPT-ve subjects (P = NS). Morphological abnormalities on thyroid ultrasound were detected in 7 of 14 (50%) PPT + ve and 7 of 9 (77%) PPT - ve subjects (P = NS). There was a strong association between abnormalities of iodide organification and morphology: of 11 subjects with positive iodide perchlorate discharge tests, 10 had abnormal (positive) ultrasound scans; of 12 subjects with negative iodide perchlorate discharge tests 8 had negative ultrasound scans (P = 0.013, Fisher's exact test). CONCLUSIONS: Long-term subtle defects of thyroid function and morphology are common in women with anti-TPO antibodies in pregnancy, whether or not they develop post-partum thyroiditis. The clinical significance of these findings is unclear but a continuing thyroid pathological process is suggested.

Adult↗
PubMed1994

Serum thyroglobulin: an early indicator of autoimmune post-partum thyroiditis.

OBJECTIVE: The aim of this study was to assess whether autoimmune thyroid damage in post-partum thyroiditis was accompanied by a significant rise in the concentration of thyroglobulin in the serum and whether its measurement could be useful in the prediction of the risk and severity of an episode of post-partum thyroid dysfunction. PATIENTS: Fifty-one women, who had taken part in a larger survey of post-partum thyroiditis, were selected at random for this study. Fourteen women without elevated circulating thyroid autoantibodies and 21 with raised thyroid autoantibodies remained euthyroid throughout the post-partum year. A third group of 14 women had raised thyroid autoantibody levels and showed one or more episodes of thyroid dysfunction during the course of the first year post partum. MEASUREMENTS: Thyroid autoantibodies were measured by ELISA, free T3 and free T4 by the Amerlex M method and TSH by an immunoradiometric method. Serum thyroglobulin was measured by a method free from interference by circulating endogenous thyroglobulin autoantibodies. Thyroid ultrasonography was performed using a General Electric RT3600 scanner operating at 7.5 MHz. RESULTS: Fourteen control women had a mean serum thyroglobulin concentration of 3.3 micrograms/l (SD 4.4; range < 1-12 micrograms/l; 95% confidence interval up to 6.0 micrograms/l). Twenty-one thyroid autoantibody positive euthyroid women had a mean serum thyroglobulin level of 5.8 micrograms/l (SD 6.2; range < 1-36 micrograms/l) which was not significantly different from that seen in the control group. Sixteen thyroid autoantibody positive women who showed one or more episodes of thyroid dysfunction during the post-partum period had a mean serum thyroglobulin of 31 micrograms/l (SD 24.8; range up to 88 micrograms/l) and this was significantly elevated compared with both the control and antibody positive groups (P < 0.001). Serum thyroglobulin concentrations at 3 months post partum correlated with the degree of post-partum hypothyroidism (as indicated by the maximum TSH and the minimum free thyroxine concentrations post partum) and, in those cases where thyroid ultrasound examinations were performed, with the degree of lymphocytic infiltration of the thyroid gland. CONCLUSIONS: The data presented in this paper confirm the destructive nature of post-partum thyroiditis and indicate that the measurement of serum thyroglobulin concentration could assist in the identification of those women at risk of post-partum thyroiditis.

Autoantibodies↗
PubMed1994

The role of complement in the pathogenesis of postpartum thyroiditis.

Postpartum thyroiditis (PPT) affects half of the 10% of women who have elevated circulating thyroid autoantibodies during the postpartum year. Because of the similarities between PPT and Hashimoto's thyroiditis, the pathogenic role of complement in PPT has been investigated. Complement fixation by thyroid peroxidase antibodies (TPO Abs) (expressed as log reciprocal titer) in serum from euthyroid TPO Ab-positive women (n = 29) was 0.91 at 1 month postpartum and increased to 1.45 by 12 months postpartum; complement C3 activation, measured by enzyme-linked immunosorbent assay, in a similar group of women (n = 75) was 0.05 at delivery and increased to 0.33 by 6 months postpartum. In women with PPT, there was greater TPO Ab-related complement activation during the postpartum year; complement fixation increased from 1.00 at 1 month postpartum to 1.48 at 4 months postpartum (P < 0.005) (n = 25), and C3 activation increased from 0.11 at delivery to 0.63 at 6 months postpartum (P < 0.005) (n = 73). Bioactive TPO Ab (TPO Ab x C3 index) was significantly higher in PPT women (55 kilo international units of activity (kIU)/L at 6 months postpartum) (Hashimoto range, 30-108 kIU/L) compared with euthyroid TPO Ab-positive women (< 9 kIU/L at all time points; P < 0.005). Serum samples from TPO Ab-negative control women showed no interaction with complement in either assay at any time during the postpartum year (complement fixation < 0.7; complement C3 activation index < 0.01). This detailed examination of the role of complement in the pathogenesis of PPT shows that TPO Ab-driven complement fixation is a marker for thyroid dysfunction in TPO Ab-positive women. The levels of bioactive TPO Ab in PPT fall within the range seen in Hashimoto's thyroiditis, suggesting similarities in their pathology.

Autoantibodies↗
PubMed1994

Proper selection of patients for intermediate-dose pure follicle stimulating hormone.

Forty-four polycystic ovary syndrome (PCO) patients were treated for a total of 61 cycles with intermediate-dose pure follicle stimulating hormone (FSH). Patient selection was based on hyperandrogenism, oligoovulation and physical signs. Patients with multiple-factor infertility were excluded from the study. Seventeen conception cycles occurred in 17 patients (pregnancy cycles). The spontaneous abortion rate was 29.4%. Forty cycles did not result in conception (Nonpregnancy cycles, 23 patients). Treatment was discontinued in four patients who had suboptimal response. Sixteen pregnancies (94%) occurred within the first two treatment cycles. Pregnancy and nonpregnancy cycles were compared for characteristics associated with a successful outcome. The data suggest that (1) an intermediate-dose pure FSH protocol is most likely to be successful among more "classic" PCO patients, those with obesity, high body surface area, elevated luteinizing hormone/FSH ratio and higher testosterone; (2) if pregnancy is to occur, it is most likely to within two treatment cycles; and (3) ovarian hyperstimulation is more likely to occur in nonconception cycles.

Abortion, Spontaneous↗
PubMed1992

Association between postpartum thyroid dysfunction and thyroid antibodies and depression.

OBJECTIVE: To define the relation between mood and autoimmune thyroid dysfunction during the eight months after delivery. DESIGN: Double blind comparison of the psychiatric status of women positive and negative for thyroid antibodies. Clinical examination and blood sampling for free triiodothyronine and thyroxine, thyroid stimulating hormone, and thyroid antibody concentrations at four weekly intervals. Psychiatric assessment at six, eight, 12, 20, and 28 weeks post partum. SETTING: Outpatient department of district hospital. PATIENTS: 145 antibody positive women and 229 antibody negative women delivering between August 1987 and December 1989. MAIN OUTCOME MEASURES: Thyroid status. Number of cases of mental ill health by the general health questionnaire, research diagnostic criteria, Hamilton 17 item depression scale, hospital anxiety and depression scale, and Edinburgh postnatal depression scale. RESULTS: Six weeks after delivery the general health questionnaire showed 62 (43%) antibody positive women and 65 (28%) antibody negative women had mental ill health (chi 2 = 8.18, p less than 0.005). Follow up of 110 antibody positive and 132 antibody negative women showed significantly greater depression by research diagnostic criteria in antibody positive women (47%) than antibody negative women (32%) regardless of thyroid dysfunction. Antibody positive women showed higher mean scores for depression on the Hamilton (6.01 v 3.89, p = 0.0002), Edinburgh (7.45 v 5.92, p = 0.031), and hospital depression scales (4.95 v 3.79, p = 0.003). CONCLUSION: Depressive symptoms are associated with positive thyroid antibody status in the postpartum period.

Autoantibodies↗
PubMed1992

The sonographic appearances in postpartum thyroiditis.

During the postpartum period about 50% of women with circulating thyroid autoantibodies develop a transient autoimmune thyroiditis. To determine the sonographic appearances in postpartum thyroiditis (PPT), serial ultrasound (US) scans of the thyroid were performed in 135 postpartum women who were divided into three clinical groups: Group 1, 37 antibody positive subjects who developed PPT; Group 2, 28 antibody positive subjects in whom thyroid function remained normal; Group 3, 70 antibody negative controls. Thyroid hypoechogenicity was observed in 14/31 patients (45%) who were scanned between 4 and 8 weeks postpartum and who subsequently developed PPT (Group 1) compared with 4/24 patients (17%) in Group 2 (P less than 0.05) and 1/65 patients (1.5%) in Group 3 (P less than 0.001). In antibody positive patients, the positive predictive value of an abnormal scan during this period was 78%. Between 15 and 25 weeks postpartum thyroid hypoechogenicity was present in 32/37 patients (86%) in Group 1 compared with 11/28 patients (39%) in Group 2 (P less than 0.001) and 2/70 patients (3%) in Group 3 (P less than 0.001). Sonographic abnormality persisted beyond 32 weeks postpartum in 36/41 antibody positive patients (87%) who had exhibited thyroid hypoechogenicity earlier during the study and who had late scans. The characteristic US appearance in PPT is thyroid hypoechogenicity. The role of sonography in the prediction, diagnosis and follow up of patients with PPT is discussed.

Autoantibodies↗