Right lobe, transverse scan

Right lobe, longitudinal scan

Right lobe, color Doppler mode

Left lobe, transverse scan

Left lobe, longitudinal scan

Left lobe, color Doppler mode

Clinical data: A 33-year-old woman requested an evaluation of a thyroid dysfunction. The patient gave birth 5 months ago. Two months before the present study, the TSH was < 0.001 mIU/L, the FT4 was 26.9 pM/L. She has not taken any medicine so far for thyroid disease. She experienced fatigue, palpitations and hair loss.

Palpation: no abnormality.

Laboratory tests: TSH < 0.001 mIU/L, FT4 15.5 pM/L, aTPO 302 U/mL, TSAb < 0.3 U/L.

Ultrasonography. The thyroid was echonormal and presented moderately hypoechoic areas. The echogenicity index was around 15%. The vascularity was decreased.

Suggestion: beta-blocking drug as required. Repeat hormonal evaluation in 3 months.

Summary of ultrasound and laboratory data:

Date of examination	Volume of the thyroid (mL)	Basic echogenicity	Vascularity	Results of laboratory investigations
	Right lobe			TSH (mIU/L)	FT4 (pM/L)
5 months after delivery	8.8	Echonormal	Low	< 0.001	15.5
9 months after delivery	19.1	Deeply hypoechoic	Increased	18.0	7.9
12 months after delivery	10.8	Moderately hypoechoic	Average	3.0	9.3
4 months after delivery	9.9	Minimally hypoechoic/echonormal	Very low	0.01	14.7
11 months after delivery	9.8	Minimally hypoechoic	Average	3.7	9.2

 

Comment.

Post partum thyroiditis could be detected after two deliveries in this patient. It is worth noting that both biochemical and ultrasound data were very similar at the same time after deliveries, i.e. at the first and fourth and at the third and the fifth examination.