A case report of subacute thyroiditis during pregnancy: difficulties in differential diagnosis and changes in cytokine levels

Abstract

Introduction. Thyroid dysfunction during pregnancy may result in both maternal and neonatal complications. Subacute thyroiditis (SAT) is an extremely rare cause of both hyper- and hypothyroidism in pregnant women.

Case description. A case of first trimester SAT is presented. Diagnosis of SAT was based on fine-needle aspiration biopsy. The disease resolved spontaneously without need for prednisone administration but a hypothyroid phase treated with T4 throughout pregnancy occurred. The pregnancy resulted in a healthy full term infant. We measured various cytokine levels in an attempt to follow their course during SAT as well as throughout the remaining period of pregnancy. Serum thyreoglobulin (Tg) levels correlated best with thyroid function tests (TFTs) and the course of SAT.

Conclusions. The diagnosis of SAT at a pregnancy setting may be intriguing. The measurement of circulating cytokines is not helpful in the differential diagnosis or monitoring of the disease.

Keywords:

• Subacute thyroiditis
• pregnancy
• hyperthyroidism
• cytokines
• FNAB

Acknowledgements

We are indebted to Dr. Bougiouklis Dimitrios, biologist, Laboratories “Analysis”, Thessaloniki, Greece, and Dr Chrysa Papadopoulou, MD, Biochemistry Department, 424 Military Hospital, Thessaloniki, Greece for their invaluable help in the measurements of the studied parameters.