Is focal chronic autoimmune thyroiditis an age-related disease? Differences in incidence and severity between Japanese and British
Autoimmune diseases occur when the body makes proteins, called antibodies, that attack and destroy the body's own tissues. Examples of autoimmune diseases (and the body parts affected) include rheumatoid arthritis (joints), multiple sclerosis (nerves), insulin-dependent diabetes (pancreas), myasthenia Gravis (muscles), and chronic lymphocytic thyroiditis (thyroid), which is also called focal thyroiditis or Hashimoto's disease. It has been suggested that autoimmune diseases are more common in the elderly, as the immune system slowly breaks down during the aging process. A recent study reported that the incidence of lymphocytic thyroiditis in British patients increased with increasing age and was more common in females than in males. However, no such relationship between disease and age or sex was found when similar studies were performed in a Japanese population. To investigate these findings, the incidence of focal thyroiditis was determined in autopsy samples of thyroid tissue from 1,826 Japanese and 810 British subjects. For the Japanese samples, the incidence of focal thyroiditis was almost twice as high in females (22 percent of the samples) as in males (14 percent), and the incidence was lower than in British females (43 percent) and males (19 percent). The only apparent relationship between disease and age occurred in British females, who showed an increase in disease occurring in those over 60 years of age. It is concluded that racial factors may influence the incidence of focal thyroiditis, but that it is not necessarily related to age. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Pathology
How common is postpartum thyroiditis? A methodologic overview of the literature
Postpartum thyroiditis is the inflammation of the thyroid gland occurring in the first year post partum (after childbirth). It is associated with changes in the normal activity of the thyroid gland and often resolves spontaneously. Various studies suggest that postpartum thyroiditis results from abnormal changes in the immune or natural defense system that occur in the postpartum period. The incidence of postpartum thyroiditis was reported to range from 1.9 to 16.7 percent, and this wide range may be due to bias or lack of objectivity in the analysis of research results. To remove the effects of bias, criteria were developed for research methods and applied to the findings of previous studies of the epidemiology of postpartum thyroiditis. The studies that fulfilled the methodologic criteria produced a narrow range of incidences of postpartum thyroiditis, varying between 3.7 and 5.9 percent. Thyrotoxicosis, a toxic condition resulting from hyperactivity of the thyroid gland, occurred more frequently in the first three months after childbirth than hypothyroidism, or decreased thyroid gland activity. In addition, impaired thyroid function after childbirth was associated with increased levels of antimicrosomal antibody, an abnormal immune or natural defense protein that specifically binds to microsomes, particles located in the cell nucleus. The findings suggest that postpartum thyroiditis is a common condition, and the best estimate of its incidence is 4.9 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Women at risk for postpartum-onset major depression
Postpartum depression (PPD) occurs in 7% to 17% of women and varies in severity. A history of depressive episodes predisposes to PPD, but PPD may be the first occurrence. Stress and lack of support may play a role in developing PPD. Research into hormonal explanations has produced contradictory results. Little is known about the effectiveness of strategies to prevent and treat PPD. Obstetricians should identify women at high risk. Special efforts should be made to educate these women about PPD during pregnancy. Emotional complaints more than two weeks after giving birth or physical complaints in healthy women should be followed up. Mood and other depressive symptoms should be evaluated at the routine follow-up appointment. Diagnosis of PPD should be followed by education. Antidepressant medication, psychotherapy, or in certain cases, electroconvulsive therapy are treatment options. Breastfeeding complicates the prescription of medications.
Publication Name: American Journal of Obstetrics and Gynecology
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