Crise tireotóxica associada à doença trofoblástica gestacional

Abstract

Background and objectives: Human chorionic gonadotropin (HCG) and thyrotrophic hormone (TSH) have analogies in their structures, as well as in their receptors. The high levels of HCG seen in gestational trophoblastic diseases may induce secondary hyperthyroidism. The objective of this report was to present a case in which the administration of iodinated contrast triggered a thyrotoxic crisis. Case report: Patient with complete hydatidiform mole who was admitted to the operating room with severe vaginal bleeding after a tomographic exam with iodinated contrast. During anesthetic induction, the patient presented symptoms compatible with thyrotoxic crisis. Conclusions: The incidence of severe presentations associated with gestational trophoblastic disease tends to decrease with early diagnosis. Still, the anesthesiologist should be aware of the possibility of those patients developing thyrotoxic crisis.

Hipertireoidismo clínico em paciente com mola hidatiforme: relato de caso

“…Almeida et al 23 report on the case of an amenorrhea patient who suffered from abdominal pain and vaginal bleeding, who presented tachypnea, tachycardia (112 bpm), hypertension (165/92 mmHg), paleness, and dehydration. Laboratory exams on admission showed TSH 0.009 mU/mL and values of hCG over 400,000 UI/L.…”

Molar pregnancy and thyroid storm - literature review

“…It is estimated that HCG serum concentrations above 200,000 mIU/ml suppress TSH in 67% of cases,and levels above 400,000 mIU/ml induces suppression in 100% of cases . [10] [11] Several studies showed that there is an indirect proportional relationship between TSH and hCG with a hCG peak level at about 10-12 weeks of gestationin normal pregnancy , and this peak level is associated with an increased level of thyroidian hormones (free T3 and free T4). (Figure 2) [12] [13] Concomitent with the hCG peak the serum levels of TSH are suppressed "in mirror image".…”