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[Children with hyperthyroidism due to elevated hCG levels]

Jasper J Jöbsis1, A S Paul van Trotsenburg, Johannes H M Merks

  • 1Tergooi, afd. Kindergeneeskunde, Blaricum.

Nederlands Tijdschrift Voor Geneeskunde
|November 13, 2014
PubMed

Insights

Elevated human chorionic gonadotropin (hCG) can cause hyperthyroidism in children, mimicking thyroid-stimulating hormone (TSH) and leading to high estradiol. This diagnosis is crucial for antibody-negative thyrotoxicosis.

Area of Science:

  • Endocrinology
  • Pediatric Endocrinology
  • Reproductive Endocrinology

Background:

  • Hyperthyroidism in children can have various causes.
  • Human chorionic gonadotropin (hCG) shares structural similarities with thyroid-stimulating hormone (TSH).
  • Elevated hCG levels can potentially impact thyroid function and pubertal development.

Observation:

  • Two pediatric cases of hyperthyroidism secondary to elevated hCG are presented.
  • One patient had gestational trophoblastic disease, and the other had choriocarcinoma.
  • The high-dose hook effect can interfere with hCG testing, complicating diagnosis.

Findings:

  • hCG can activate the TSH receptor, leading to hyperthyroidism.
  • hCG's luteinizing hormone (LH)-mimicking effect can cause elevated estradiol levels.
  • This hormonal imbalance can result in stormy pubertal development.

Implications:

  • hCG-induced hyperthyroidism should be considered in antibody-negative thyrotoxicosis.
  • Accurate hCG testing is vital for diagnosing this condition.
  • Understanding hCG's dual hormonal effects is important for pediatric endocrine management.

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