HYPERTHYROIDISM IN GESTATIONAL TROPHOBLASTIC NEOPLASIA

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Abstract
The thyroid status of twenty‐seven African patients with gestational trophoblastic neoplasia (GTN) was studied. Fifteen patients were found to be biochemically hyperthyroid (eight patients with choriocarcinoma; seven with hydatidiform mole). Of these fifteen patients, nine were clinically thyrotoxic. The most serious complication of thyrotoxicosis was life‐threatening acute pulmonary oedema with associated cardiac failure. It was found that when serum levels of the human chorionic gonadotrophin (hCG) reached a level of about 0·1 ± 106 iu/l, thirteen of sixteen patients were biochemically hyper‐thyroid; at serum levels of 0·3 ± 106 iu/l of hCG most patients were clinically thyrotoxic. A feature of hyperthyroidism associated with GTN is that whereas T4 is invariably raised the T3:T4 ratio tends to be low (0·015 ± 005); rT3:T3 ratios were high in this group. TSH levels were not increased.

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