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Finding of thyroid disfunction in group of pregnant women
Urválek, Jiří ; Zima, Tomáš (advisor) ; Límanová, Zdeňka (referee)
Diseases of the thyroid gland are very common, affecting about 5% of inhabitants, mainly woman. Pregnancy influences thyroid function in multiple ways. In normal pregnant women, the thyroid gland maintains euthyroidism with only minor fluctuations in serum FT4 and TSH. However, in women with limited thyroid reserve hypothyroidism can develop. We had a study group with 1720 pregnant woman coming to screening of Down syndrom in 1.trimester of pregnancy. By their agreeing we investigated levels of TSH, anti TPO, resp. FT4. Gestational hyperthyroidism is uncommon, low level of TSH may be caussed by high concentration of hCG, thyrotropic activity of this hormon is well known. In study group were 62 pregnant woman (3,6%) with TSH < 0,1 mU/l and 10 (0,58%) with FT4 > 22 pmol/l. In group with low TSH (< 0,1 mU/l) was arithemic mean of free hCG (120,4 ug/l) significantly higher than in groups with normal or higher TSH level (63,2 resp. 64,9 ug/l). Hypothyroidism is predictive of reduced neonatal and child neuropsychological development and maternal obstetric complications. We found an elevated serum TSH concentration (TSH > 4,0 mU/l) in 5,0 % of 1720 pregnant women. Ten of those 85 (10,6%) women had concentration of FT4 < 10 pmol/l. Postpartum thyroid dysfunction (PPTD) is associated with antithyroid peroxidase...
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Evaluation of pilot project examination of thyroid gland function in group of pregnant women
Drncová, Jana ; Límanová, Zdeňka (referee) ; Springer, Drahomíra (advisor)
In 2009 took place in selected regions of the Czech Republic pilot project examination of thyroid gland function, through which was tested the proposed scheme of screening of pregnant women. In terms of screening for congenital defects were women in the 1st trimester of pregnancy investigated with the informed consent on TSH, FT4 and anti-TPO in serum. In the case of positive result, woman has been informed immediately and she was undertaken in care of endocrinologist. The project involved 13 pre-selected laboratories. To determine the analyte were used immunoassay methods which differed in individual laboratories and so were also used different reference intervals too. In frame of the project was examined a group of 2843 women with an average age of 29,4 years. In total were captured 19,6% women with a positive finding. From the whole investigated group had elevated TSH 235 women (8.5%), of whom had reduced FT4 34. Reduced level of TSH had 96 females (3.5%), of whom had a slightly elevated FT4 14 women. Elevated anti-TPO had 9% of women. The outcome of the project showed what is the willingness for cooperation between gynecologists and laboratories and where are the weaknesses of the project. It was verified the economic aspects of screening and also was confirmed relatively large number of women who...
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Progression of thyroid diseases in women with thyroid gland disorder diagnosed during pregnancy
Krejčová, Simona ; Límanová, Zdeňka (referee) ; Springer, Drahomíra (advisor)
Diploma thesis is based on a four-year study the goal which was to demonstrate on a group of pregnant and postpartum women the frequency and severity of thyroid disease in pregnancy and after childbirth, and thus support the introduction of screening of function thyreidopathias into normal practice within screening for congenital defects in first trimester of pregnancy. In 3937 sera from women in the 10th - 12 week of pregnancy were, with informed consent of pregnant, determined TSH and anti TPO, in the case of FT4 deviation. Of the total number of examined 6,4 % had TSH higher than 4,00 mIU/l, 4,2 % with TSH less than 0,1 mIU/l and 12,4 % of women with positive anti TPO antibodies. 552 women were recommended visiting endocrinology. 106 pregnant women came to be endocrinologically tested to Third Internal Clinic of VFN and 1st LF UK which is the equivalent to 19,2 % of all positive hits and 2,7 % of all investigated over the period. Only 56 women (52,8 %), came for subsequent checks in which the monitoring of the disease continued. After the endocrinologic examination in pregnancy 60,4 % of women was diagnosed with subclinical hypothyroidism. This subclinical form developed in 39 % of women into an overt hypothyroidism 24 - 30 months after childbirth. Overall, the disease progressed in 41.1% of women....
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Pendrin in the pathogenesisof congenital hypothyroidism
Banghová, Karolína ; Lebl, Jan (advisor) ; Límanová, Zdeňka (referee) ; Houšťková, Hana (referee) ; Stárka, Luboslav (referee)
Pendrin is an anion transporter that is expressed in several organs. In the thyroid gland, pendrin is localized at the apical pole of thyrocytes and it is responsible for the iodide efflux from thyrocytes into the colloid in the follicular lumen where iodide is organificated. The extrathyroidal expression was shown in the inner ear, kidney, placenta and mammary gland. Carriers of mutations in the pendrin gene (PDS, SLC26A4) display variable phenotypical features following the autosomal recessive manner of the inheritance: combined thyroid and hearing affection (Pendred syndrome - OMIM274600), nonsyndromic autosomal recessive neurosensory deafness (DFNB4 - OMIM600791) or isolated enlarged vestibular aqueduct (EVA - OMIM603545). The thyroid affection is usually manifested as euthyroid or hypothyroid goitre in the second decade of life. In a minority of patients, dyshormonogenesis is present at birth, and the disease is diagnosed in the frame of the nation-wide neonatal screening for congenital hypothyroidism.
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