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Recurrent hyperthyroidism in consecutive pregnancies characterized by hyperemesis
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston 77030, USA.
Thyroid : Official Journal of the American Thyroid Association
|October 1, 1996
Summary
Recurrent hyperemesis gravidarum in three pregnancies was linked to transient hyperthyroidism, suggesting a role for human chorionic gonadotropin (hCG). This hCG-mediated hyperthyroidism resolved spontaneously in the second trimester of each pregnancy.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Maternal-Fetal Medicine
Background:
- Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy.
- Thyroid dysfunction, including hyperthyroidism, can occur during pregnancy.
- Human chorionic gonadotropin (hCG) is a key hormone in pregnancy and shares structural similarities with thyroid-stimulating hormone (TSH).
Observation:
- A 34-year-old woman experienced recurrent hyperemesis and abnormal thyroid function tests indicative of hyperthyroidism in three consecutive singleton pregnancies.
- These symptoms consistently resolved during the second trimester of each pregnancy.
- Transient hyperthyroidism was documented in two of the three pregnancies.
Findings:
- The recurrent pattern of hyperemesis and transient hyperthyroidism across multiple pregnancies suggests a common underlying mechanism.
- Human chorionic gonadotropin (hCG)-mediated hyperthyroidism is a likely cause, given the hormone's thyrotropic properties.
- Potential mechanisms include trophoblasts synthesizing high-grade thyrotropic hCG or maternal modification of hCG to enhance thyrotropic activity.
Implications:
- This case highlights the potential for hCG to cause significant maternal thyroid dysfunction.
- Understanding hCG's role in hyperthyroidism can improve diagnosis and management of HG.
- Further research into hCG variants and their thyrotropic activity is warranted.