Recurrent spontaneous abortions, Hashimoto thyroiditis and alopecia totalis: response to anticoagulation and intravenous immunoglobulin therapy

Gynecol Endocrinol. 2014 Feb;30(2):100-2. doi: 10.3109/09513590.2013.864271. Epub 2013 Dec 6.

Abstract

Introduction: Although numerous studies indicated a link between antithyroid antibodies and recurrent spontaneous abortions (RSA), consensus on the treatment of this condition is still lacking.

Case report: We present a case of a 35-year-old pregnant woman (gestation week 4) with primary hypothyroidism, total alopecia, high level of positive antithyroid antibodies, and history of two recurrent spontaneous abortions in early pregnancy. Along with L-thyroxin substitution, intravenous human immunoglobulin (IVIg) combined with anticoagulation and antiaggregation therapy was introduced. During pregnancy her scalp hair completely re-grew, and following gestation week 39 she delivered healthy female child.

Conclusion: Thyroid antibodies could contribute to previous recurrent abortions in our patient. It is suggested that in older primiparas with Hashimoto thyroiditis and history of RSA, a combined treatment with IVIg, anticoagulation and antiaggregation therapy should be considered.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Habitual / drug therapy*
  • Abortion, Habitual / etiology
  • Adult
  • Alopecia / complications
  • Alopecia / drug therapy*
  • Anticoagulants / therapeutic use*
  • Female
  • Hashimoto Disease / complications
  • Hashimoto Disease / drug therapy*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Pregnancy
  • Pregnancy Outcome
  • Thyroxine / therapeutic use*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Immunoglobulins, Intravenous
  • Thyroxine