Transient Non-Autoimmune Hyperthyroidism of Early Pregnancy

Goldman, Alexander M.; Mestman, Jorge H.

doi:10.4061/2011/142413

Cited by 49 publications

(62 citation statements)

References 57 publications

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“…Case studies have indicated that, serum levels of hCG of >100,000 mIUL -1 are usually needed to produce clinical evidence of thyrotoxicosis [3]. Such high levels are seen in conditions like hyperplacentosis, hyperemesis gravidarum, gestational trophoblastic disease, multiple pregnancy and hyper reaction-luteinalis [7]. These conditions are associated with the clinical entity known as 'transient non autoimmune hyperthyroidism in early pregnancy' wherein hCG is the main mediator of hyperthyroidism [7].…”

Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

“…Such high levels are seen in conditions like hyperplacentosis, hyperemesis gravidarum, gestational trophoblastic disease, multiple pregnancy and hyper reaction-luteinalis [7]. These conditions are associated with the clinical entity known as 'transient non autoimmune hyperthyroidism in early pregnancy' wherein hCG is the main mediator of hyperthyroidism [7]. weeks gestation, changes in serum hCG and TSH are mirror images of each other, and there is a significant negative correlation between the individual TSH (nadir) and peak hCG levels.…”

Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

“…Harada showed an increase of free T 4 and free T 3 associated with the peak hCG [37,38].Serum TSH levels particularly between 7 and 12 weeks of gestation fall to a nadir and present a mirror image with peak hCG values. (fig 7) The lower normal TSH limits in first trimester is approximately 0.03-0.08 mIUL -1 secondary to the thyrotropic activity of hCG [7].…”

Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

“…The incidence of molar pregnancy has been reported to range between 0.5 and 2 to 2.5 per one thousand pregnancies [7,8,9]. In some Asian countries, the incidence is as high as 1 in 82 pregnancies [1].…”

Section: Hydatidiform Molementioning

confidence: 99%

“…Patients with a complete molar pregnancy have excessively high levels of serum and urinary hCG resulting from trophoblastic proliferation [1]. hCG serves as a marker for the tumour.The diagnosis is made by ultrasonogram demonstrating a snowstorm appearance without a foetus (fig 3) [7].…”

Section: Types Of Hydatidiform Mole -Molar Pregnancies Are Categorisementioning

confidence: 99%

See 4 more Smart Citations

Trophoblastic Hyperthyroidism and Its Perioperative Concerns

Kurdi¹

2014

Thyroid Disorders - Focus on Hyperthyroidism

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Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

Section: Relationship Between Hcg and Thyroidmentioning

confidence: 99%

Section: Hydatidiform Molementioning

confidence: 99%

Section: Types Of Hydatidiform Mole -Molar Pregnancies Are Categorisementioning

confidence: 99%

See 3 more Smart Citations

Trophoblastic Hyperthyroidism and Its Perioperative Concerns

Kurdi¹

2014

Thyroid Disorders - Focus on Hyperthyroidism

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Graves' Disease Pharmacotherapy in Women of Reproductive Age

2016

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Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence-based practice.

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