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Submitted
December 30, 2019
Accepted
December 30, 2019
Published
December 30, 2019
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Abstract

Thyrotoxicosis defined as a clinical manifestation of excess circulating thyroid hormone. Epidemiologic investigation reports 0.2% of thyrotoxicosis is caused by hydatidiform mole. The New England Trophoblastic Disease Centre (NETDC) mentioned that 20% of hydatidiform mole cases have thyrotoxicosis as one of its complications. The basic pathogenesis of thyrotoxicosis is the similarity of the HCG subunit to TSH which results in excessive stimulation of thyroid hormone. We present thethyrotoxicosis case in a 15-weeks pregnant woman with complete hydatidiform mole. The patient admitted to the hospital with  blackish-red coloured bleeding and several hyperthyroidism complaints, laboratory test showed elevated levels of HCG and thyroid hormone and decreased TSH. Imaging studies done with ultrasound showed with snowflake pattern. The patient then treated with thyroid hormone suppressant therapy before the hydatidiform mole evacuation. Normalization of thyroid hormone levels should be made immediately before the mole evacuation to avoid life-threatening thyroid storm complications.

Keywords

thyrotoxicosis hydatidiform mole pregnancy HCG

Article Details

How to Cite
Nugraha, G. B. A., & Samodro, P. (2019). Case study: Thyrotoxicosis on women with complete hydatidiform molar pregnancy. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 10(3), 292–297. https://doi.org/10.20885/JKKI.Vol10.Iss3.art13
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References

  1. Alwi I, Salim S, Hidayat R, Kurniawan J, Tahapary DL. Panduan praktis klinis tirotoksikosis. Penatalaksanaan di Bidang Ilmu Penyakit Dalam. Jakarta: Interna Publishing; 2015.
  2. Jameson JL, Weetman AP. Disoreder of the thyroid gland. Horrison’s Principles of Internal Medicine. 18 th. New York: McGraw-Hill; 2012.
  3. Kurdi MS. Trophoblastic hyperthyroidism and its perioperative concerns. In: Thyroid disorders - focus on hyperthyroidism. 2014.
  4. Paputungan T V, Wagey FW, Lengkong RA. Profil penderita mola hidatidosa di RSUP Prof.dr.R.D. Kandou Manado. e-CliniC. 2016.
  5. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Gestational thropoblastic disease. Williams Obstetrics. 25 th. New York: McGraw-Hill; 2018. p: 388.
  6. Virmani S, Srinivas SB, Bhat R, Rao R, Kudva R. Transient thyrotoxicosis in molar pregnancy. Journal of Clinical and Diagnostic Research. 2017;11(7).
  7. Sabir A, Abubakar S, Fasanmade O, Haruna G, Iwuala S, Ohwovoriole A. Correlation between Wayne's score and laboratory evidence of thyrotoxicosis in Nigeria. Sub Saharan African Journal of Medicine. 2014;1(3):142-4.
  8. Samra T, Kaur R, Sharma N, Chaudhary L. Peri-operative concerns in a patient with thyroid storm secondary to molar pregnancy. Indian Journal of Anaesthesia. 2015;59(11):739-42.
  9. Secretariat of The Indoneisan Society of Endocrinology and Metabolism Departement of Internal Medicine. Indonesian clinical practice guidelines for hyperthyroidism. Journal of the ASEAN Federation of Endocrine Societies. 2012.
  10. Blick C, Schreyer K. Gestational trophoblastic disease-induced thyroid storm. Clinical Practice and Cases in Emergency Medicine. 2019; 3(4):409-12.
  11. Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. International Journal of Gynecology & Obstetrics. 2018; 143(Suppl 2):79-85.
  12. Filipescu GA, Solomon OA, Clim N, Milulescu A, Boiangiu AG, Mitran M. Molar pregnancy and thyroid storm - literature review. ARS Medica Tomitana. 2017;23(3):121-5.
  13. Simes BC, Mbanaso AA, Zapata CA, Okoroji CM. Hyperthyroidism in a complete molar pregnancy with a mature cystic ovarian teratoma. Thyroid Research. 2018;11(12):1-5.
  14. Hegedüs L. Treatment of graves’ hyperthyroidism: Evidence-based and emerging modalities. Endocrinology and Metabolism Clinics of North America. 2009;38(2):355-71.
  15. Khanna P, Dehran M, Kumar A. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management. Journal of Obstetric Anaesthesia and Critical Care. 2012;2(1):31-3.