Volume : 7, Issue : 4, April - 2018

Hyperthyroidism in Gestational Trophoblastic Disease: A rare entity

Dr. Rajni Dawar, Dr. Manushri Sharma, Dr. Meenakshi Singh, Dr. Preeti Chauhan, Dr. Smita Tripathi, Dr. Anju Jain

Abstract :

<p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Background</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Hyperthyroidism is less common than hypothyroidism in pregnancy. A rare cause of thyrotoxicosis during pregnancy is gestational trophoblastic disease (GTD). <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Aims/Objectives</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> : To perform thyroid function testing in two suspected cases of GTD and its follow up.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Material Methods</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">: Two patients of GTD presented for &beta; hCG and TFT measurement, which were estimated by chemiluminescent immunoassay.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Results:</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> First case had &beta; hCG levels 2,34,000 and TFT (TSH = 0.06&mu;IU/ml, FT4 = 1.97 ng/dl, FT3 = 5.16 pg/ml) and second case had &beta; hCG 2,76000 with TFT (TSH &ndash; 0.07 &mu;IU/ml; FT4 = 2.14ng/dl; FT3 = 4.34pg/ml). TFT and &beta;-hCG was repeated after suction evacuation. They remained elevated and normalised at 5^thday in case one while it took 2 weeks to normalise in case two.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion</span></b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: The development of hyperthyroidism is largely influenced byhCG level and usually resolves with treatment of GTD. Hyperthyroidism in pregnancy should be diagnosed early and managed efficaciously before suction evacuation of hydatidiform mole.<o:p></o:p></span></p>