The human chorionic gonadotropin molecule from patients with trophoblastic diseases has a high thyrotropic activity but is less active in the ovary

Kato, Koji; Mostafa, M.; Mann, Klaus; Schindler, A. E.; Hoermann, Rudolf

doi:10.1080/09513590410001667247

Cited by 27 publications

(17 citation statements)

References 21 publications

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“…Others have suggested that the length of time hCG is elevated plays a role (13). Still others have suggested that differences in hCG glycosylation or sialylation that is seen in patients with GTD and HG results in increased thyrotropic activity (6,(17)(18)(19)(20). In the present study, it is clear that absolute hCG concentrations are higher in women with GTD.…”

Section: Commentsupporting

confidence: 69%

Serum Human Chorionic Gonadotropin Concentrations Greater than 400,000 IU/L Are Invariably Associated with Suppressed Serum Thyrotropin Concentrations

Lockwood

Grenache

Gronowski

2009

Thyroid

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Lockwood, Christina M.; Grenache, David G.; and Gronowski, Ann M., ,"Serum human chorionic gonadotropin concentrations greater than 400,000 IU/L are invariably associated with suppressed serum thyrotropin concentrations." Thyroid.19,8. 869-868. (2009 Background: During pregnancy, when human chorionic gonadotropin (hCG) concentrations are highest, there is a transient suppression of serum thyrotropin (TSH). In normal pregnancy, TSH concentrations generally remain within nonpregnant reference intervals; however, in some patients TSH is suppressed. Here we sought to extend previous studies to examine the relationship between very high serum concentrations of hCG (>200,000 IU=L) and the thyroid hormones TSH and free thyroxine (FT 4 ). The objective of this study was to determine: 1) if there is an hCG concentration above which TSH concentrations are suppressed (0.2 mIU=mL); 2) how thyroid hormone concentrations change in response to changes in hCG concentrations; and 3) the clinical symptoms in patients with such extremely elevated hCG concentrations. Methods: Residual specimens sent to the laboratories for physician-ordered hCG testing were utilized. Over 26 months, 15,597 physician-ordered hCG tests were performed. Sixty-nine specimens from 63 women with hCG concentrations >200,000 IU=L were identified, and TSH and FT 4 concentrations were measured. Medical records were reviewed for clinical information.Results: Thirty-seven percent of subjects had hyperemesis gravidarum (HG) and 19% had gestational trophoblastic disease (GTD). TSH was suppressed (0.2 mIU=mL) in 67% of the specimens with hCG concentrations >200,000 IU=L and 100% of specimens with hCG concentrations >400,000 IU=L. FT 4 concentrations were elevated above the reference interval (1.8 ng=dL) in 32% of specimens with hCG concentrations >200,000 IU=L and in 80% of specimens with hCG concentrations >400,000 IU=L. Only four subjects had documented signs of hyperthyroidism. Women with GTD had a median hCG concentration twofold higher than women with HG and a median TSH concentration one half that of women with HG. Conclusions: 1) At hCG concentrations >400,000 IU=L, TSH is consistently suppressed; 2) serum FT 4 and TSH respond to changes in serum hCG concentrations; and 3) most patients with hCG concentrations >200,000 IU=L lack overt hyperthyroid symptoms.

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Section: Commentsupporting

confidence: 69%

Serum Human Chorionic Gonadotropin Concentrations Greater than 400,000 IU/L Are Invariably Associated with Suppressed Serum Thyrotropin Concentrations

Lockwood

Grenache

Gronowski

2009

Thyroid

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“…Prevalence of hyperthyroidism during complete molar pregnancy is as high as 7% [1]. Thyroid hyper function in molar pregnancy is attributed to excess of human chorionic gonadotropin which has a weak intrinsic thyroid stimulating activity and molar thyrotrophic hormone, differing from Human Chorionic Gonadotropin (HCG) by being larger in molecular size and longer in duration of action [4] clinical hyperthyroidism because trophoblastic disease is cured by evacuation of molar tissue [5]- [8].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Hormone Levels and Its Relationship with Human Chorionic Gonadotropin in Patients with Hydatidiform Mole

Nankali¹,

Keshavarzi²,

Jalilian³

et al. 2016

OJOG

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Objective: Hydatidiform pregnancy occurs in 1:1000 pregnancies worldwide; incidence is higher in Asian countries. In approximately 5% of cases of hydatidiform mole, clinical hyperthyroidism is present. The aim of this study was to examine the relation between HCG level and thyroid function test. Methods: During 5 years (2009-2013) we included 146 cases of molar pregnancies into the study at Imam Reza teaching hospital. The demographic and clinical data as well as serum initial HCG level and thyroid function test (TSH T3 T4) were retrieved and entered into prepared proformas. p < 0.05 was considered significant. Result: The mean age of patients was 29.31 years; mean of gestational age was 11.71 weeks; mean of gravidity was 2.32; mean of serum BHCG was 3.88E4; mean of T4 was 11.07 and mean of T3 was 1.97. In this study significantly inverse relation was observed between B-HCG and TSH (p = 0.05). We also found a significantly direct correlation between B-HCG and T3 (p = 0.01) and T4 (p = 0.01). Conclusion: We concluded significantly meaningful relationship between BHCG and T3, T4, TSH.

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“…The values are severalfold higher than normal and can stimulate thyroid function (43). hCG secreted by a mole can also have greater thyrotropic potency than hCG secreted in normal pregnancy.…”

Section: Excess Tsh-like Materials and Gestational Trophoblastic Diseasesmentioning

confidence: 99%

Uncommon Causes of Thyrotoxicosis

Mittra¹,

Niederkohr²,

Rodríguez³

et al. 2008

J Nucl Med

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Apart from the common causes of thyrotoxicosis, such as Graves' disease and functioning nodular goiters, there are more than 20 less common causes of elevated free thyroid hormones that produce the symptoms and signs of thyrotoxicosis. This review describes these rarer conditions and includes 14 illustrative patients. Thyrotropin and free thyroxine should be measured and, when the latter is normal, the free triiodothyronine level should be obtained. Measurement of the uptake of 123 I is recommended for most patients.

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The human chorionic gonadotropin molecule from patients with trophoblastic diseases has a high thyrotropic activity but is less active in the ovary

Cited by 27 publications

References 21 publications

Serum Human Chorionic Gonadotropin Concentrations Greater than 400,000 IU/L Are Invariably Associated with Suppressed Serum Thyrotropin Concentrations

Serum Human Chorionic Gonadotropin Concentrations Greater than 400,000 IU/L Are Invariably Associated with Suppressed Serum Thyrotropin Concentrations

Thyroid Hormone Levels and Its Relationship with Human Chorionic Gonadotropin in Patients with Hydatidiform Mole

Uncommon Causes of Thyrotoxicosis

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