Objectives: Gestational hypothyroidism is associated with obstetric complications and disturbances in the offspring development;however, it remains easy to treat. The objective of the study was to describe thyroid-sti...Objectives: Gestational hypothyroidism is associated with obstetric complications and disturbances in the offspring development;however, it remains easy to treat. The objective of the study was to describe thyroid-stimulating hormone (TSH) levels in pregnant women and analyze their association with pregnancy course and outcome. Design: This national, observational, retrospective study analyzed data on Lebanese pregnant women visiting their obstetrician as part of their routine follow up. Participants, Setting and Methods: Enrolled subjects were all pregnant women who visited the obstetrics clinic from 01 September 2017 until 31 August 2018, as part of their routine follow up and have a TSH level record. In 2020, during their routine follow-up visit, the participants signed an informed consent to allow the investigator to access the data retrospectively and enter them into his database. Relevant participant characteristics and outcome data were collected from clinic files of the private clinic of Dr Abi Tayeh, at the Department of Obstetrics and Gynecology, H?tel-Dieu de France University Hospital, Beirut, Lebanon. Results: A total of 419 women were enrolled, 11.5% of them reported at least one comorbidity prior to pregnancy, most often the antiphospholipid syndrome, followed by thrombophilia and hypothyroidism. At least one complication was reported for 18.4% of participants. Around 87.6% of participants delivered a full-term baby with normal birth weight for most. The average TSH value for all participants was within the normal range at all time-points. Highest TSH values were recorded during the first trimester. As treatment was immediately initiated in women with abnormal TSH levels, no correlation was observed between TSH levels and pregnancy outcomes or pregnancy complications at any time-point. Conclusions: This study highlights satisfactory routine practice in the management of thyroid disorders in pregnancy and underscores the need for routine TSH screening for all pregnant women.展开更多
BACKGROUND Cronkhite–Canada syndrome(CCS)is a rare sporadic polyposis syndrome that presents with gastrointestinal and ectodermal symptoms in addition to nutritional deficiencies.CCS combined with hypothyroidism is a...BACKGROUND Cronkhite–Canada syndrome(CCS)is a rare sporadic polyposis syndrome that presents with gastrointestinal and ectodermal symptoms in addition to nutritional deficiencies.CCS combined with hypothyroidism is an even rarer condition,with no standard treatment guidelines.CASE SUMMARY The present study described 2 patients with CCS:A 67-year-old woman with concomitant hypothyroidism and 68-year-old man treated with endoscopic mucosal resection(EMR).Both patients had multiple gastrointestinal symptoms and ectodermal changes,along with multiple gastrointestinal polyps.Microscopic examination showed that the mucosa in both patients was hyperemic and edematous,with pathologic examination showing distorted,atrophic,and dilated glands.Patient 1 had concomitant hypothyroidism and was treated with levothyroxine.Due to her self-reduction of hormone dose,her disease relapsed.Patient 2 underwent EMR,but refused further hormonal or biological treatments.Subsequently,he was treated with an oral Chinese medical preparation.CONCLUSION Pharmacotherapy can induce and maintain remission in CCS patients,with adjuvant EMR,long-term follow-up,and endoscopic surveillance being necessary.Case 1:Based on the aforementioned findings,Patient 1 was diagnosed with CCS and hypothyroidism.Case 2:Based on the aforementioned findings,Patient 2 was diagnosed with CCS.展开更多
文摘Objectives: Gestational hypothyroidism is associated with obstetric complications and disturbances in the offspring development;however, it remains easy to treat. The objective of the study was to describe thyroid-stimulating hormone (TSH) levels in pregnant women and analyze their association with pregnancy course and outcome. Design: This national, observational, retrospective study analyzed data on Lebanese pregnant women visiting their obstetrician as part of their routine follow up. Participants, Setting and Methods: Enrolled subjects were all pregnant women who visited the obstetrics clinic from 01 September 2017 until 31 August 2018, as part of their routine follow up and have a TSH level record. In 2020, during their routine follow-up visit, the participants signed an informed consent to allow the investigator to access the data retrospectively and enter them into his database. Relevant participant characteristics and outcome data were collected from clinic files of the private clinic of Dr Abi Tayeh, at the Department of Obstetrics and Gynecology, H?tel-Dieu de France University Hospital, Beirut, Lebanon. Results: A total of 419 women were enrolled, 11.5% of them reported at least one comorbidity prior to pregnancy, most often the antiphospholipid syndrome, followed by thrombophilia and hypothyroidism. At least one complication was reported for 18.4% of participants. Around 87.6% of participants delivered a full-term baby with normal birth weight for most. The average TSH value for all participants was within the normal range at all time-points. Highest TSH values were recorded during the first trimester. As treatment was immediately initiated in women with abnormal TSH levels, no correlation was observed between TSH levels and pregnancy outcomes or pregnancy complications at any time-point. Conclusions: This study highlights satisfactory routine practice in the management of thyroid disorders in pregnancy and underscores the need for routine TSH screening for all pregnant women.
基金Jilin Provincial Science and Technology Department Project,No.20200201343JCScience and Technology Development Program of Jilin Province,No.20210402013GH.
文摘BACKGROUND Cronkhite–Canada syndrome(CCS)is a rare sporadic polyposis syndrome that presents with gastrointestinal and ectodermal symptoms in addition to nutritional deficiencies.CCS combined with hypothyroidism is an even rarer condition,with no standard treatment guidelines.CASE SUMMARY The present study described 2 patients with CCS:A 67-year-old woman with concomitant hypothyroidism and 68-year-old man treated with endoscopic mucosal resection(EMR).Both patients had multiple gastrointestinal symptoms and ectodermal changes,along with multiple gastrointestinal polyps.Microscopic examination showed that the mucosa in both patients was hyperemic and edematous,with pathologic examination showing distorted,atrophic,and dilated glands.Patient 1 had concomitant hypothyroidism and was treated with levothyroxine.Due to her self-reduction of hormone dose,her disease relapsed.Patient 2 underwent EMR,but refused further hormonal or biological treatments.Subsequently,he was treated with an oral Chinese medical preparation.CONCLUSION Pharmacotherapy can induce and maintain remission in CCS patients,with adjuvant EMR,long-term follow-up,and endoscopic surveillance being necessary.Case 1:Based on the aforementioned findings,Patient 1 was diagnosed with CCS and hypothyroidism.Case 2:Based on the aforementioned findings,Patient 2 was diagnosed with CCS.