Nader S, Mastrobattista J
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston 77030, USA.
Thyroid. 1996 Oct;6(5):465-6. doi: 10.1089/thy.1996.6.465.
A 34-year-old Caucasian woman was seen and evaluated for hyperemesis and abnormal thyroid function tests, consistent with hyperthyroidism, during her second pregnancy. Her hyperemesis and hyperthyroidism both resolved during the second trimester of this pregnancy. She recounted very similar symptoms of similar duration in her first pregnancy. She was again monitored in a third pregnancy during which hyperemesis and hyperthyroidism were once more documented, resolving during the second trimester. The recurrence of hyperemesis in three consecutive singleton pregnancies, with documentation of transient hyperthyroidism in two of these pregnancies, is suggestive of human chorionic gonadotropin (hCG)-mediated hyperthyroidism. Either the trophoblasts synthesized hCG of high thyrotropic grade or, alternatively, hCG could be modified in the maternal tissues, resulting in molecules with greater thyrotropic activity. These potential mechanisms are discussed.
一名34岁的白人女性在第二次怀孕期间因妊娠剧吐和甲状腺功能检查异常（符合甲状腺功能亢进症）前来就诊并接受评估。她的妊娠剧吐和甲状腺功能亢进症在此次妊娠的中期均得到缓解。她讲述了自己第一次怀孕时出现过持续时间相似的类似症状。她在第三次怀孕时再次接受监测，在此期间再次记录到妊娠剧吐和甲状腺功能亢进症，同样在中期得到缓解。连续三次单胎妊娠均出现妊娠剧吐复发，其中两次妊娠记录到短暂性甲状腺功能亢进症，提示可能是由人绒毛膜促性腺激素（hCG）介导的甲状腺功能亢进症。要么是滋养层细胞合成了高促甲状腺素活性的hCG，要么是hCG在母体组织中发生了修饰，从而产生了具有更高促甲状腺素活性的分子。文中对这些潜在机制进行了讨论。
