Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 6/2009

01-12-2009 | Case Report

Extended hyperemesis gravidarum in a patient after total thyroidectomy

Authors: T. J. F. Blankenstein, F. Kainer, K. Friese, I. Mylonas

Published in: Archives of Gynecology and Obstetrics | Issue 6/2009

Login to get access

Abstract

Introduction

Human chorionic gonadotropin is regarded as, at least, one of the main factors responsible for hyperemesis gravidarum by direct stimulation of the thyroid gland on the basis of a close homology to the structure of TSH. However, questions to this theory of hCG-induced gestational hyperthyroidism still remain.

Case report

We present for the first time a rare case of hyperemesis gravidarum in a patient with a previous removed thyroid gland and an adequate thyroxin replacement. In this case report we present an extended hyperemesis gravidarum in a patient after total thyroidectomy and thus artificially well-set thyroid parameters.

Conclusion

Although transient hyperthyroidism is widely thought to be causative of a hyperemesis during pregnancy, this case report with a mildly hypothyroidism emphasizes that there might be other, yet unknown, factors that can cause such a severe complication.
Literature
1.
go back to reference Stricker R, Echenard M, Eberhart R, Chevailler MC, Perez V, Quinn FA (2007) Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur J Endocrinol 157:509–514. doi:10.1530/EJE-07-0249 CrossRefPubMed Stricker R, Echenard M, Eberhart R, Chevailler MC, Perez V, Quinn FA (2007) Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur J Endocrinol 157:509–514. doi:10.​1530/​EJE-07-0249 CrossRefPubMed
2.
go back to reference Mylonas I, Gingelmaier A, Kainer F (2007) Nausea and vomiting in pregnancy. Dtsch Arztebl 104:A-1821–A-1826 Mylonas I, Gingelmaier A, Kainer F (2007) Nausea and vomiting in pregnancy. Dtsch Arztebl 104:A-1821–A-1826
3.
go back to reference Yoshimura M, Hershman JM, Pang XP, Berg L, Pekary AE (1993) Activation of the thyrotropin (TSH) receptor by human chorionic gonadotropin and luteinizing hormone in Chinese hamster ovary cells expressing functional human TSH receptors. J Clin Endocrinol Metab 77:1009–1013. doi:10.1210/jc.77.4.1009 CrossRefPubMed Yoshimura M, Hershman JM, Pang XP, Berg L, Pekary AE (1993) Activation of the thyrotropin (TSH) receptor by human chorionic gonadotropin and luteinizing hormone in Chinese hamster ovary cells expressing functional human TSH receptors. J Clin Endocrinol Metab 77:1009–1013. doi:10.​1210/​jc.​77.​4.​1009 CrossRefPubMed
9.
10.
go back to reference Tsuruta E, Tada H, Tamaki H, Kashiwai T, Asahi K, Takeoka K, Mitsuda N, Amino N (1995) Pathogenic role of asialo human chorionic gonadotropin in gestational thyrotoxicosis. J Clin Endocrinol Metab 80:350–355. doi:10.1210/jc.80.2.350 CrossRefPubMed Tsuruta E, Tada H, Tamaki H, Kashiwai T, Asahi K, Takeoka K, Mitsuda N, Amino N (1995) Pathogenic role of asialo human chorionic gonadotropin in gestational thyrotoxicosis. J Clin Endocrinol Metab 80:350–355. doi:10.​1210/​jc.​80.​2.​350 CrossRefPubMed
11.
14.
go back to reference Depue RH, Bernstein L, Ross RK, Judd HL, Henderson BE (1987) Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am J Obstet Gynecol 156:1137–1141PubMed Depue RH, Bernstein L, Ross RK, Judd HL, Henderson BE (1987) Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am J Obstet Gynecol 156:1137–1141PubMed
15.
go back to reference Jordan V, Grebe SK, Cooke RR, Ford HC, Larsen PD, Stone PR, Salmond CE (1999) Acidic isoforms of chorionic gonadotrophin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotrophic. Clin Endocrinol (Oxf) 50:619–627. doi:10.1046/j.1365-2265.1999.00702.x CrossRef Jordan V, Grebe SK, Cooke RR, Ford HC, Larsen PD, Stone PR, Salmond CE (1999) Acidic isoforms of chorionic gonadotrophin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotrophic. Clin Endocrinol (Oxf) 50:619–627. doi:10.​1046/​j.​1365-2265.​1999.​00702.​x CrossRef
Metadata
Title
Extended hyperemesis gravidarum in a patient after total thyroidectomy
Authors
T. J. F. Blankenstein
F. Kainer
K. Friese
I. Mylonas
Publication date
01-12-2009
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 6/2009
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1026-z

Other articles of this Issue 6/2009

Archives of Gynecology and Obstetrics 6/2009 Go to the issue