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Thyrotoxicosis: a rare presentation of molar pregnancy
  1. Eison De Guzman1,
  2. Hira Shakeel2 and
  3. Rohit Jain2
  1. 1Department of Internal Medicine, The George Washington University Hospital, Washington, District of Columbia, USA
  2. 2Department of Endocrinology and Metabolism, The George Washington University Hospital, Washington, District of Columbia, USA
  1. Correspondence to Dr Eison De Guzman; icydeg1{at}gmail.com

Abstract

A 49-year-old woman, G8P7, presented with 1 week of worsening vaginal bleeding and abdominal cramps in the setting of a recently discovered unplanned pregnancy. Vaginal ultrasound findings and a significantly elevated human chorionic gonadotropin (hCG) level were concerning for molar pregnancy. She developed signs of hyperthyroidism on the night of admission, for which the endocrinology team was consulted. Laboratory data were consistent with hyperthyroidism. The patient was believed to have thyrotoxicosis secondary to molar pregnancy with concern for impending thyroid storm. Her mental health disorder and bacteraemia made taking care of her further challenging. She was started on a beta-blocker, antithyroid agent and intravenous corticosteroids. She underwent an uncomplicated suction dilation and curettage (D&C), with resolution of her symptoms a few days after. At a follow-up appointment, the patient continued to be asymptomatic and was feeling well.

  • thyroid disease
  • thyrotoxicosis
  • pregnancy

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Footnotes

  • Contributors EDG, HS and RJ were directly involved in the patient’s care. EDG and HS drafted the manuscript under the supervision of RJ, who provided guidance for the final manuscript. All authors contributed to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.