Serum human chorionic gonadotropin levels and thyroid hormone levels in gestational transient thyrotoxicosis: Is the serum hCG level useful for differentiating between active Graves&amp;rsquo; disease and GTT?

Yoshihara, Ai; Noh, Jaeduk Yoshimura; Mukasa, Koji; Suzuki, Miho; Ohye, Hidemi; Matsumoto, Masako; Kunii, Yo; Watanabe, Natsuko; Suzuki, Nami; Kameda, Toshiaki; Sugino, Kiminori; Ito, Koichi

doi:10.1507/endocrj.ej14-0596

Cited by 25 publications

(8 citation statements)

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“…This finding is consistent with a enhanced peripheral conversion of T4, in response to caloric deprivation, to the inactive reverse triiodothyronine (rT3), the concentrations of which have been found to be increased in women with HG [28], [29], [30]. Also, since in GTT patients free T4 levels are usually more elevated than serum free T3, a decreased FT3/FT4 ratio has been proposed as a biochemical parameter useful for differentiating between GTT and active GD [31].…”

Section: Gestational Transient Thyrotoxicosis (Gtt)supporting

confidence: 65%

Hyperthyroidism in the pregnant woman: Maternal and fetal aspects

Moleti

Mauro

Sturniolo

et al. 2019

Journal of Clinical & Translational Endocrinology

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Hyperthyroidism during pregnancy is uncommon. Nonetheless, prompt identification and adequate management of hyperthyroidism in a pregnant woman is essential, because uncontrolled thyrotoxicosis significantly increases the risk of maternal and fetal complications. Also, fetal prognosis may be affected by the transplacental passage of maternal thyroid stimulating antibodies or thyrostatic agents, both of which may disrupt fetal thyroid function. Birth defects have been reported in association with the use of antithyroid drugs during early pregnancy. Although rarely, offspring of mothers with Graves’ disease may develop fetal/neonatal hyperthyroidism, the management of which requires a close collaboration between endocrinologists, obstetricians, and neonatologists. Because of the above considerations, the management of pregnant and lactating women with hyperthyroidism requires special care, bearing in mind that both maternal thyroid excess per se and related treatments may adversely affect the newborn’s health. In this review we discuss the diagnosis and management of hyperthyroidism in pregnancy, along with the impact of thyrotoxicosis and medications on fetal outcome.

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Section: Gestational Transient Thyrotoxicosis (Gtt)supporting

confidence: 65%

Hyperthyroidism in the pregnant woman: Maternal and fetal aspects

Moleti

Mauro

Sturniolo

et al. 2019

Journal of Clinical & Translational Endocrinology

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“…The FT 3 /FT 4 ratio was 1.31 10 −2 pg/ng (a ratio <2.7 10 −2 pg/ng is suggestive of gestational thyrotoxicosis instead of active Graves disease). 13 However, the patient had no signs or symptoms of thyrotoxicosis. There was no family history of thyroid The patient's condition improved after 3 days of fluid and electrolyte replacement: intravenous (IV) normal saline with potassium 40 mEq/L at a rate of 100 mL/hour, vitamin B6 100 mg orally twice daily, IV thiamine 100 mg daily for 3 days (for prevention of Wernicke encephalopathy), IV dimenhydrinate 50 mg every 6 hours as needed, and metoclopramide 10 mg orally 3 times daily before meals.…”

Section: Case Reportmentioning

confidence: 86%

Jaundice Caused by Hyperemesis Gravidarum

Pornchai

Kamalaporn

Sriphrapradang

2022

TOJ

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Background: Hyperemesis gravidarum is characterized by intractable vomiting and associated with weight loss exceeding 5% of prepregnancy body weight, dehydration, and ketosis. Hyperemesis gravidarum occurs during the first trimester and typically resolves by 16 to 20 weeks of gestation. Approximately half of all hospitalized females with hyperemesis gravidarum have a mild elevation in liver enzymes; however, jaundice and hepatic synthetic dysfunction are uncommon. Case Report: A 22-year-old gravida 1 para 0 in her ninth week with a singleton gestation was hospitalized with persistent nausea, vomiting, weight loss of 11% of her prepregnancy body weight, dehydration, hypokalemia, and jaundice. Liver function tests showed hyperbilirubinemia of 7.1 mg/dL and alanine aminotransferase levels high as 676 U/L. Other hepatobiliary diseases were excluded. Thyroid function tests revealed thyrotoxicosis. Gestational thyrotoxicosis is often associated with hyperemesis gravidarum because of their shared pathophysiology of high human chorionic gonadotropin levels during the first trimester. After supportive management including hydration, correction of electrolyte disturbance, vitamin supplementation, and antiemetic treatment, the patient's symptoms resolved. Liver and thyroid dysfunction returned to normal after resolution of vomiting. The patient delivered a healthy child at 38 weeks' gestation. Conclusion: Elevation of aminotransferase and bilirubin levels may occur in patients with hyperemesis gravidarum. Although jaundice and highly elevated liver enzymes have been reported, investigations to exclude preexisting and concurrent liver diseases are required. Management of hyperemesis gravidarum is supportive, and outcomes are generally favorable.

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“…Studies have shown that TGF-β1 and miR-99a are associated with changes in pathological phenomena of pregnancy and hormone levels during pregnancy. TGF-β1 expression is low in the serum of pregnant womens peripheral blood, and the elevated expression level of miR-99a will inhibit hormone expression levels during pregnancy (16,20). In this study, the expression of TGF-β1 and miR-99a in early spontaneous abortion and the correlation with the levels of serum β-HCG, progesterone and estrogen during pregnancy were investigated.…”

Section: Discussionmentioning

confidence: 99%

Expression of TGF-β1 and miR-99a in serum of patients with early spontaneous abortion and correlation with hormone levels during pregnancy

Xie

Cao

2019

Exp Ther Med

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Expression of TGF-β1 and miR-99a in patients with early spontaneous abortion and correlation with hormone levels during pregnancy were investigated. A total of 70 pregnant women with early spontaneous abortion diagnosed in Jining No. 1 People's Hospital from February 1, 2015 to May 1, 2018 were selected as the study group, and 83 normal pregnant women who chose abortion for non-medical reasons in the same period as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect TGF-β1 and the levels of serum β-HCG, progesterone and estrogen during pregnancy in the two groups, and RT-qPCR to detect the expression of miR-99a, and partial correlation analysis to analyze the correlation of TGF-β1 and miR-99a with the levels of serum β-HCG, progesterone and estrogen in the study group of patients. Expression of β-HCG was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001), and that of progesterone was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001). Expression of estrogen was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001). The partial correlation analysis indicated that the levels of serum β-HCG, progesterone and estrogen were positively correlated with TGF-β1 (r=0.944, 0.868, 0.869, P<0.001), negatively correlated with the expression level of miR-99a (r=−0.944, −0.892, −0.891, all P<0.001). miR-99a was highly expressed in the serum of patients with early spontaneous abortion, but TGF-β1 expression was low. The expression levels of the two factors are related to hormone levels during pregnancy, which are expected to be new candidate molecular diagnostic markers in the diagnosis of early spontaneous abortion.

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Serum human chorionic gonadotropin levels and thyroid hormone levels in gestational transient thyrotoxicosis: Is the serum hCG level useful for differentiating between active Graves’ disease and GTT?

Cited by 25 publications

References 10 publications

Hyperthyroidism in the pregnant woman: Maternal and fetal aspects

Hyperthyroidism in the pregnant woman: Maternal and fetal aspects

Jaundice Caused by Hyperemesis Gravidarum

Expression of TGF-β1 and miR-99a in serum of patients with early spontaneous abortion and correlation with hormone levels during pregnancy

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