Fellow In Endocrinology UTHSC Memphis Memphis, Tennessee, United States
Introduction : Incidence of hyperthyroidsm in pregnancuy is 0.1 to 0.4%. A twin pregnancy with complete hydatidiform mole is also a rare occurance 1 in 22 000 to 1 in 100 000 pregnancy. We had a case of twin pregnacy with complete hydatidiform mole with hyperthyroidsm.
Case(s) Description : 25 yr F G3 P1011 with past medical history of hypertension, obesity came to emergency with vaginal bleeding, nausea, vomiting, palpitation, and abdominal pain. On the physical exam, she was tachycardic and hypertensive and had diffusely enlarged goiter. Pelvic USG revealed a single live fetus with cystic placental changes concerning partial molar pregnancy. Laboratory evaluation showed significantly elevated beta HCG, elevated T3, and Free T4 with suppressed TSH. She was treated for thyroid storm from molar pregnancy. She received propyl thiouracil, propranolol and underwent D and C with clinical improvement. The pathology of the fetus revealed a dizygotic twin with complete mole. Thyroid stimulating immunoglobulin came back high raising the possibility of underlying Graves’ disease.
Discussion : Termination of pregnancy resulted in significant improvement in her symptoms. Serial monitoring of HCG showed decreasing levels. She was placed on methimazole post D and C with improvement in her hyperthyroidsm.
