J Korean Soc Endocrinol.  2005 Jun;20(3):294-298. 10.3803/jkes.2005.20.3.294.

A Case of Hashimoto's Thyroiditis with Transient T3-Thyrotoxicosis Induced by Hydatidiform Mole

• Yoo JY
• Moon HJ
• Park CY
• Lee SJ
• Jeong IK
• Hong EG
• Oh GW
• Kim HK
• Kim DM
• Yoo JM
• Ihm SH
• Choi MG
• Yoo HJ
• Park SW
• Min SK

• KMID: 2200572
• DOI: http://doi.org/10.3803/jkes.2005.20.3.294

Abstract

Human chorionic gonadotropin(HCG) is a member of the glycoproteins family synthesized by the placenta, which consists of 2 noncovalently joined subunits(alpha(alpha) and beta(beta)). The alpha- and beta-subunits have a structural homology with the alpha- and beta-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so beta-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic disease (GTD), such as a hydatidiform mole or a choriocarcinoma, but the clinical symptoms of hyperthyroidism are rarely observed. We experienced a case of Hashimoto's thyroiditis, where the patient was diagnosed with T3-thyrotoxicosis, which had initially been induced by excess beta-HCG due to an H-mole; after evacuation of the H-mole, the condition was diagnosed as hypothyroidism. It has been speculated that a patient with Hashimoto's thyroiditis could have hyperthyroidism, induced by beta-HCG, due to an H-mole

MeSH Terms

Choriocarcinoma
Chorion
Female
Gestational Trophoblastic Disease
Glycoproteins
Humans
Hydatidiform Mole*
Hyperthyroidism
Hypothyroidism
Placenta
Pregnancy
Receptors, Thyrotropin
Thyroid Gland*
Thyroiditis*
Glycoproteins
Receptors, Thyrotropin

Figure

• 

  Fig. 1 Pelvis MRI shows uterus enlargement (11×8×12 cm) and tiny cystic mass was filled in uterine cavity. The mass shows T1 low-T2 bright signal intensity and mesh-like enhancement.

• 

  Fig. 2 Microscopic findings of endometrium shows hyperplastic trophoblasts on edematous enlarged villi (H&E, ×40)

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  Fig. 3 Time course of serum thyroid hormone, TSH and β-HCG

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  Fig. 4 Thyroid aspiration cytology shows some follicular cells showing small sized nuclei with smooth membrane and abundant cytoplasm. Many lymphocytes are scattered (Pap, ×200)

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