The hyperthyroidism in gestational trophoblastic disease: a case report
DOI:
https://doi.org/10.18203/2349-3933.ijam20233209Keywords:
Hyperthyroidism, Gestational trophoblastic disease, ThyroidAbstract
Gestational trophoblastic disease, also referred to as GTD, is an extremely rare form of pregnancy-related complication that can arise. It covers a wide range of conditions, from choriocarcinoma to molar pregnancy. Patients who are diagnosed with gestational trophoblastic disease have an increased likelihood of developing hyperthyroidism. It is speculated that this occurs as a result of molecular mimicry that exists between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH), which results in cross-reactivity with the TSH receptor. This would explain why the two molecules would react similarly to each other. The gestational trophoblastic disease-induced thyroid storm is an extremely rare but potentially fatal complication that can arise during pregnancy. It is necessary to detect and treat this complication as soon as possible in order to prevent additional complications from occurring. Once the patient's hemodynamic status has been stabilized, the removal of the mole is the primary component of the definitive treatment that will be administered. In most cases, hyperthyroidism usually resolves once the gestational trophoblastic disease has been successfully treated and the hCG levels have been brought back to normal.
References
Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376(9742):717-29.
Pereira JV, Lim T. Hyperthyroidism in gestational trophoblastic disease - a literature review. Thyroid Res. 2021;14(1):1.
Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol. 2010;203(6):531-9.
Hershman JM. Physiological and pathological aspects of the effect of human chorionic gonadotropin on the thyroid. Best Pract Res Clin Endocrinol Metab. 2004;18(2):249-65.
Kaulfers AM, Bhowmick SK. Molar Pregnancy Causing Thyrotoxicosis in a Teenage Girl With Type 1 Diabetes Mellitus. Glob Pediatr Health. 2015;2:2333794X15574285.
Moskovitz JB, Bond MC. Molar pregnancy-induced thyroid storm. J Emerg Med. 2010;38(5):e71-6.
Chiniwala NU, Woolf PD, Bruno CP, Kaur S, Spector H, Yacono K. Thyroid storm caused by a partial hydatidiform mole. Thyroid. 2008;18(4):479-81.
Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593-646.
Devereaux D, Tewelde SZ. Hyperthyroidism and thyrotoxicosis. Emerg Med Clin N Am. 2014;32(2):277-92.
Kofinas JD, Kruczek A, Sample J, Eglinton GS. Thyroid storm-induced multi-organ failure in the setting of gestational trophoblastic disease. J Emerg Med. 2015;48(1):35-8.
Hou JL, Wan XR, Xiang Y, Qi QW, Yang XY. Changes of clinical features in hydatidiform mole: analysis of 113 cases. J Reprod Med. 2008;53(8):629-33.
Adali E, Yildizhan R, Kolusari A, Kurdoglu M, Turan N. The use of plasmapheresis for rapid hormonal control in severe hyperthyroidism caused by a partial molar pregnancy. Arch Gynecol Obstet. 2009;279(4):569-71.
Azezli A, Bayraktaroglu T, Topuz S, Kalayoglu-Besisik S. Hyperthyroidism in molar pregnancy: rapid preoperative preparation by plasmapheresis and complete improvement after evacuation. Transfus Apheresis Sci. 2007;36(1):87-9.
Erbil Y, Tihan D, Azezli A, Salmaslioglu A, Ozluk Y, Buyukoren A, et al. Severe hyperthyroidism requiring therapeutic plasmapheresis in a patient with hydatidiform mole. Gynecol Endocrinol. 2006;22(7):402-4.
Clinical Research Centre. Efficacy and Safety of Cholestyramine and Prednisolone as Adjunctive Therapy in Treatment of Overt Hyperthyroidism. Malaysia. 2017.
