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Pituitary-thyroid function in trophoblastic disease.

K Miyai, O Tanizawa, T Yamamoto

    The Journal of Clinical Endocrinology and Metabolism
    |February 1, 1976
    PubMed
    Summary
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    Trophoblastic disease can cause abnormal thyroid stimulation, leading to elevated thyroid hormones and suppressed TSH. Treatment normalizes thyroid function and restores TSH response.

    Area of Science:

    • Endocrinology
    • Oncology
    • Reproductive Medicine

    Background:

    • Trophoblastic disease, including hydatidiform mole, invasive mole, and choriocarcinoma, can affect endocrine function.
    • Pituitary-thyroid axis regulation is crucial for metabolic homeostasis.

    Purpose of the Study:

    • To investigate pituitary-thyroid function in patients with trophoblastic disease.
    • To identify potential thyroid-stimulating factors associated with trophoblastic tumors.

    Main Methods:

    • Assessed pituitary-thyroid function in 12 patients with trophoblastic disease using McKenzie bioassay and radioimmunoassay for TSH, TRH, T4, and T3.
    • Compared hormone levels and TSH response to TRH between patients with detectable and undetectable thyroid-stimulating activity.

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    Main Results:

    • Six patients exhibited detectable thyroid-stimulating activity, with undetectable TSH and blunted TRH response.
    • These patients also had significantly higher serum concentrations of total T4, free T4, total T3, and free T3 compared to those without detectable activity.
    • Treatment led to decreased thyroid hormone levels, normalized TSH response to TRH, and loss of detectable thyroid-stimulating activity.

    Conclusions:

    • An abnormal thyroid stimulator, originating from trophoblastic tissue, likely stimulates thyroid hormone secretion.
    • This stimulator suppresses the pituitary's TSH response to TRH in some patients with trophoblastic disease.
    • These findings highlight a unique endocrine manifestation of trophoblastic neoplasms.