Krentz A J, Redman H, Taylor K G
Department of Diabetes, Endocrinology and Lipid Metabolism, Dudley Road Hospital, Birmingham.
Br J Clin Pract. 1994 Mar-Apr;48(2):75-6.
Hyperemesis gravidarum is an uncommon presentation of hyperthyroidism in pregnancy which is usually attributable to autoimmune (Graves') disease. While this condition necessitates treatment with antithyroid drugs, a syndrome of transient hyperthyroidism associated with hyperemesis gravidarum that resolves spontaneously is also recognised. Differentiation between these two conditions may prove problematic in practice. We report two cases of hyperthyroidism associated with severe hyperemesis gravidarum. Intractable hyperemesis continued in one patient despite normalisation of circulating free thyroid hormone concentrations with carbimazole. Neither patient exhibited clinical or immunological features of autoimmune thyroid disease, suggesting in retrospect that they had the syndrome of transient hyperthyroxinaemia associated with hyperemesis gravidarum rather than Graves' disease. The role of antithyroid drugs in the treatment of self-limiting transient hyperthyroidism associated with hyperemesis gravidarum requires clarification.
妊娠剧吐是孕期甲状腺功能亢进的一种罕见表现，通常归因于自身免疫性（格雷夫斯）病。虽然这种情况需要用抗甲状腺药物治疗，但也认识到有一种与妊娠剧吐相关的短暂性甲状腺功能亢进综合征，可自行缓解。在实际操作中，区分这两种情况可能会有问题。我们报告了两例与严重妊娠剧吐相关的甲状腺功能亢进病例。尽管用卡比马唑使循环游离甲状腺激素浓度恢复正常，但一名患者的顽固性妊娠剧吐仍持续存在。两名患者均未表现出自身免疫性甲状腺疾病的临床或免疫学特征，回顾来看，提示她们患有与妊娠剧吐相关的短暂性高甲状腺素血症综合征，而非格雷夫斯病。抗甲状腺药物在治疗与妊娠剧吐相关的自限性短暂性甲状腺功能亢进中的作用需要阐明。
