A 33-year-old woman admitted for frequent vomiting when 10 weeks pregnant. She had developed diabetes mellitus at age 15 and was diagnosed as MODY. Pregnancy was detected under well-controlled conditions of 6.8% of HbA1c and normoalbuminuria. Hyperemesis gravidarum was diagnosed and parental hyperalimentation implemented. Although she had no thyrotoxic symptoms or struma, hyperthyrodism was detected (free T4 1.9 ng/dl, free T3 4.5 pg/ml, TSH<0.03 μU/m/). Since antithyroid or TSH receptor antibodies were negative and serum chorionic gonadotropin (hCG) was 147,600 mU/ml, hyperthyroidism due to elevated serum hCG was diagnosed. Her symptoms and hyperthyroidism were ameliorated along with the lowering of serum hCG until 18 weeks of gestation. In the second term, however, she developed toxemia of pregnancy and was readmitted at 31 weeks of gestation. At 36 weeks of gestation, a normal fetus was delivered by Caesarean section. After delivery, diabetic retinopathy and hypertension were transiently aggravated and urinary albumin excretion did not normalize until one year after delivery. hCG may thus induce transient hyperthyroidism and hyperemesis gravidarum due to its thyroid stimulating activity and may be related to the development of preeclampsia.
|ジャーナル||Journal of the Japan Diabetes Society|
|出版ステータス||出版済み - 2003|
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism