Abstract
Thyrotoxicosis in pregnancy can be a medical emergency requiring ICU admission. Often, however, because of the rapid onset of immune tolerance in pregnancy, Graves’ disease may be quite mild. Here we present a case of suppressed TSH in early pregnancy which had no signs of Graves’ disease and no nodules. A high hCG level indicated the diagnosis of gestational thyrotoxicosis which as far as we know is a completely benign condition requiring no treatment.
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References
Lee SY, Pearce EN. Testing, monitoring, and treatment of thyroid dysfunction in pregnancy. J Clin Endocrinol Metab. 2021;106(3):883–92. https://doi.org/10.1210/clinem/dgaa945. Up to date review
Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev. 1997;18(3):404–33. Classic review of thyroid function in pregnancy.
Davies TF, Andersen S, Latif R, Nagayama Y, Barbesino G, Brito M, Eckstein AK, Stagnaro-Green A, Kahaly GJ. Graves’ disease. Nat Rev Dis Primers. 2020;6(1):52. https://doi.org/10.1038/s41572-020-0184-y. PMID: 32616746. Up to date review.
Tomer Y, Huber GK, Davies TF. Human chorionic gonadotropin (hCG) interacts directly with recombinant human TSH receptors. J Clin Endocrinol Metab. 1992;74(6):1477–9. https://doi.org/10.1210/jcem.74.6.1317388. PMID: 1317388. First direct demonstration of hCG binding to the TSH receptor.
Pekary AE, Azukizawa M, Hershman JM. Thyroidal responses to human chorionic gonadotropin in the chick and rat. Horm Res. 1983;17(1):36–42. https://doi.org/10.1159/000179672. PMID: 6840670. Classic early demonstration of thyroid stimulating activity by hCG.
Hershman JM. Human chorionic gonadotropin and the thyroid: hyper emesis gravidarum and trophoblastic tumors. Thyroid. 1999;9(7):653–7. https://doi.org/10.1089/thy.1999.9.653. PMID: 10447009. Early association of hyperemesis with thyrotoxicosis.
Rodien P, Brémont C, Sanson ML, et al. Familial gestational hyperthyroidism caused by a mutant thyrotropin receptor hypersensitive to human chorionic gonadotropin. N Engl J Med. 1998;339:1823–6.
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Davies, T.F. (2022). A Case of Gestational Thyrotoxicosis. In: Davies, T.F. (eds) A Case-Based Guide to Clinical Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-84367-0_8
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DOI: https://doi.org/10.1007/978-3-030-84367-0_8
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