I accidentally discovered cervical enlargement 3 months after giving birth. May I ask if this is postpartum thyroiditis? What are the symptoms of postpartum thyroiditis? How can we treat it?

Painless thyroiditis, also known as postpartum thyroiditis, occurs within one year after giving birth. Painless thyroiditis is often accompanied by thyroid dysfunction. The incidence rate of postpartum thyroiditis is 5%~10%.

The causes of postpartum thyroiditis:

1. It has been proven that this disease is closely related to autoimmunity. The incidence rate of postpartum thyroiditis is as high as 30%~50% for those who are TPOAb positive in the first three months of pregnancy.

2. Genetic studies have shown that this disease has HLA antigen polymorphism.

Excessive iodine can induce postpartum thyroiditis.

4. Asymptomatic postpartum thyroiditis is particularly common in women with a history of Graves’ disease.

Clinical manifestations of postpartum thyroiditis:

1. The course of the disease is similar to painless thyroiditis, and patients are usually asymptomatic. Most of them are found during postpartum thyroid function checks, while a few are found when patients experience thyroid swelling or mild palpitations.

2. Most patients have no symptoms, while a few may experience mild edema, fatigue, and fear of cold during hypothyroidism. Many patients do not experience discomfort in the throat, while 10% to 20% of patients experience local compression or hidden pain in the thyroid area, with occasional mild tenderness.

3. The thyroid gland is mostly bilateral symmetric, diffuse, and slightly enlarged. The isthmus and conical lobe often increase simultaneously, but can also be unilateral. The thyroid gland often gradually increases with the progression of the disease, but rarely compresses the neck, causing difficulty in breathing and swallowing. During palpation, there is no adhesion between the thyroid gland and surrounding tissues, and it can move up and down during swallowing movements.

4. Cervical lymph nodes are generally not enlarged, and in a few cases, they can also be accompanied by cervical lymph node enlargement, but the texture is soft.

Treatment of postpartum thyroiditis:

Because postpartum thyroiditis is a self limiting, temporary disease with a course of only a few months; Hyperthyroidism should be treated conservatively, usually with only β- Blockers, such as propranolol, can improve palpitations, tachycardia, mental tension, tremors, and excessive sweating. Surgery and radiation therapy are contraindications. During the period of hypothyroidism, thyroid hormone replacement therapy may be necessary. Although some may be permanent hypothyroidism, most thyroid functions return to normal. Therefore, after 6-12 months postpartum, thyroid function needs to be re evaluated. If pregnant again, the disease will mostly recur.


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