Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman
Joint Authors
Jayasuriya, Anuradha
Muthukuda, Dimuthu
Dissanayake, Preethi
Subasinghe, Shyama
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-12-23
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Background.
Gestational trophoblastic disease (GTD) which includes hydatidiform mole, invasive mole, placental site trophoblastic tumor, and choriocarcinoma is a rare cause of hyperthyroidism due to excess production of placental human chorionic gonadotrophin hormone (hCG) by tumor cells.
Molecular mimicry between hCG and thyroid stimulating hormone (TSH) leads to continuous stimulation of TSH receptor by extremely high levels of hCG seen in these tumors.
Consequently, biochemical and clinical hyperthyroidism ensues and it is potentially complicated by thyrotoxic crisis which is fatal unless urgent therapeutic steps are undertaken.
Case Description.
We present a 49-year-old perimenopausal woman who presented with recurrent thyroid storm and high output cardiac failure.
The initial workup revealed suppressed TSH, high-free thyroxine (FT4), and free triiodothyronine (FT3) levels with increased vascularity of the normal-sized thyroid on ultrasonography.
She was managed with parenteral beta blockers, steroids, and high-dose carbimazole.
Her lower abdominal tenderness led to further investigations which revealed tremendously elevated beta-hCG and a snow storm appearance on transabdominal ultrasound suggestive of GTD.
She underwent curative surgery and was diagnosed with complete hydatidiform mole postoperatively by histology.
Conclusion.
Recurrent thyroid crisis in gestational trophoblastic disease is an exceedingly rare presentation and that is highly fatal.
This case highlights the importance of early detection and treatment of the etiology of thyrotoxicosis to eliminate mortality.
American Psychological Association (APA)
Jayasuriya, Anuradha& Muthukuda, Dimuthu& Dissanayake, Preethi& Subasinghe, Shyama. 2020. Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman. Case Reports in Endocrinology،Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1147118
Modern Language Association (MLA)
Jayasuriya, Anuradha…[et al.]. Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman. Case Reports in Endocrinology No. 2020 (2020), pp.1-5.
https://search.emarefa.net/detail/BIM-1147118
American Medical Association (AMA)
Jayasuriya, Anuradha& Muthukuda, Dimuthu& Dissanayake, Preethi& Subasinghe, Shyama. Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman. Case Reports in Endocrinology. 2020. Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1147118
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147118