Hyperthyroidism in molar pregnancy: β-HCG levels do not always reflect severity

Chale-Matsau, Bettina; Mokoena, Samantha; Kemp, Tanja; Pillay, Tahir S

doi:10.1016/j.cca.2020.09.028

Cited by 3 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did not find a significant association between B-hCG level (when considered less than 500,000 and equal or more than 500,000 Unit/liter) and occurrence of maternal complications ( P = 0.3). This finding was in agree with Chale-Matsau et al [ 21 ] who concluded that the β-hCG levels do not always correlate with disease severity and prognosis in patients with GTD.…”

Section: Discussionsupporting

confidence: 92%

Molar pregnancy with a coexisting living fetus: a case series

Hemida

Khashaba

Zalata

2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Coexistence of molar pregnancy with living fetus represents a challenge in diagnosis and treatment. The objective of this study to present the outcome of molar pregnancy with a coexisting living fetus who were managed in our University Hospital in the last 5 years. Methods We performed a retrospective analysis of patients who presented with molar pregnancy with a coexisting living fetus to our Gestational Trophoblastic Clinic, Mansoura University, Egypt from September, 2015 to August, 2020. Clinical characteristics of the patients, maternal complications as well as fetal outcome were recorded. The patients and their living babies were also followed up at least 6 months after delivery. Results Twelve pregnancies were analyzed. The mean maternal age was 26.0 (SD 4.1) years and the median parity was 1.0 (range 0–3). Duration of the pregnancies ranged from 14 to 36 weeks. The median serum hCG was 165,210.0 U/L (range 7662–1,200,000). Three fetuses survived outside the uterus (25%), one of them died after 5 months because of congenital malformations. Histologic diagnosis was available for 10 of 12 cases and revealed complete mole associated with a normal placenta in 6 cases (60%) and partial mole in 4 cases (40%). Maternal complications occurred in 6 cases (50%) with the most common was severe vaginal bleeding in 4 cases (33.3%). There was no significant association between B-hCG levels and maternal complications (P = 0.3). Conclusion Maternal and fetal outcomes of molar pregnancy with a living fetus are poor. Counseling the patients for termination of pregnancy may be required. Trial registration The study was approved by Institutional Research Board (IRB), Faculty of Medicine, Mansoura University (number: R.21.10.1492).

show abstract

Section: Discussionsupporting

confidence: 92%

Molar pregnancy with a coexisting living fetus: a case series

Hemida

Khashaba

Zalata

2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Despite its frequent description, the risk of thyroid storm makes it unavoidable. Bettina, 2020 14 South Africa Case report Two patients These cases illustrate that the beta-hCG levels do not necessarily have a correlation with the severity of the disease or the patient's prognosis in GTD patients. Guzman, 2021 15 United State of America (USA)…”

Section: Polandmentioning

confidence: 90%

“…β-hCG levels correspond with thyroid hormone levels. 8,9,14 Several investigations have shown that β-hCG released by hydatidiform moles and GTN differs from β-hCG in normal pregnancies. β-hCG from hydatidiform moles had considerably more thyrotropic activity than β-hCG from normal pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism Secondary to Gestational Trophoblastic Disease : A Literature Review

Bagus Sentosa

2023

JARMHS

View full text Add to dashboard Cite

Gestational trophoblastic disease (GTD) is a rare form of pregnancy-related cancer that is effectively treatable. GTD is accompanied by the potentially fatal complication of hyperthyroidism. We created a review consisting of five case reports. This case report was conducted on women who became pregnant when they were >35 years old. They showed consistent laboratory results, in which there was an increase in hCG levels. TSH and thyroid stimulating antibodies cannot account for the hyperthyroidism associated with GTD. The source of the thyroid stimulating agent is trophoblastic tissue. The thyrotropic effects of ?-hCG mediate GTD hyperthyroidism. Other research examined the prevalence of hyperthyroidism in women with normal pregnancy, hydatidiform mole, and choriocarcinoma who had ?-hCG serum levels below 100,000 IU/ml. Early prenatal screening may significantly reduce hyperthyroidism rates. Thyroid hormone synthesis inhibitors treat hyperthyroidism in pregnancy. Thioamides, propylthiouracil (PTU), and methimazole (MMI) are the most prevalent U.S. antithyroid medications (ATD). Plasmaphoresis may be an option for people who are resistant to therapy or need emergency surgery. GTD can cause fatal hyperthyroidism. Anti-thyroid medicines can handle most GTD hyperthyroidism. Surgery may be a possibility for patients refractory to medical treatment.

show abstract

“…The unique characteristics of β-hCG, specifically in trophoblastic disease, contribute to the extent of thyrotoxicosis that can be seen in these patients. The β-hCG molecules associated with trophoblastic disease are more heterogenous with degraded variations, which have been found to have 1.5-2 times more thyrotropic activity compared to physiologic β-hCG from pregnancy [4][5][6]. The presence of hydatidiform mole may also result in supranormal levels of β-hCG and can manifest as symptoms of severe hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

Severe Thyrotoxicosis Caused by Molar Pregnancy: A Case Report and Review of the Literature

Frasik¹,

Luong²,

Chang³

et al. 2023

Cureus

View full text Add to dashboard Cite

Severe thyrotoxicosis is an acute and life-threatening state of hyperthyroidism. While it is a rare presentation of hyperthyroidism, it is clinically significant because of its high mortality and necessitates early identification and treatment to reduce the incidence of poor outcomes. The most common causes of this hypermetabolic state are Graves' disease, toxic thyroid adenoma or multinodular goiter, thyroiditis, iodine-induced hyperthyroidism, and excessive intake of levothyroxine. The less common causes include trauma, medications (i.e., amiodarone), discontinuation of anti-thyroid medications, and interactions with sympathomimetic medications such as ketamine that may be administered during general anesthesia. Regardless of etiology, thyrotoxicosis management should be coordinated using an interdisciplinary team-based approach to optimize outcomes.We discuss a molar pregnancy requiring emergency surgery as an uncommon cause of thyrotoxicosis and highlight appropriate management steps. The patient's symptoms resolved post-operatively, and her postoperative laboratory results (thyroid function and beta-human chorionic gonadotropin {β-hCG}) were followed until they normalized. The patient's preoperative presentation and preparation with a multidisciplinary team discussion, intraoperative anesthetic considerations and course, and post-operative management and follow-up are described.

show abstract

Hyperthyroidism in molar pregnancy: β-HCG levels do not always reflect severity

Cited by 3 publications

References 17 publications

Molar pregnancy with a coexisting living fetus: a case series

Molar pregnancy with a coexisting living fetus: a case series

Hyperthyroidism Secondary to Gestational Trophoblastic Disease : A Literature Review

Severe Thyrotoxicosis Caused by Molar Pregnancy: A Case Report and Review of the Literature

Contact Info

Product

Resources

About