We report a case of hyperemesis gravidarum complicated by thyrotoxicosis which was managed conservatively during pregnancy. Problems of diagnosing mild thyrotoxicosis in pregnancy are discussed. Although no specific antithyroid therapy was given, the patient had an uneventful pregnancy after the first trimester. Neither she nor her baby exhibited any subsequent features of thyroid dysfunction. This suggests that treatment of thyrotoxicosis in early pregnancy is not always required because of the spontaneous improvement which is likely to occur as pregnancy progresses.
RosenthalFDJonesCLewisSI. Thyrotoxic vomiting. Brit Med. J., 1976. 2; 209–211.
2.
ValentineBHJonesCTyackAJ. Hyperemesis gravidarum due to thyrotoxicosis. Post grad. Med. J., 1980. 56: 746–747.
3.
LaoTTHChinRKHCochramCSPanesarNS. Transient hyperthyroidism in hyperemesis gradivarum. J. Royal. Soc. Med., 1986. 79: 613–615.
4.
ShewringGSmithBR. An improved radiorecpetor assay for TSH receptor antibodies. Clin. Endocrinol., 1982. 17: 409–417.
5.
WilsonRMcKillopJHPearsonPWCuthbertGFThomsonJA. Relapse of Graves' disease after medical therapy: Predictive value of thyroidal technetium-99m uptake and thyroid stimulating hormone receptor antibody levels. J. Nucl. Med., 1985. 26; 1024–1028.
6.
BouillonRNaesensMvan AsscheFADe KeyserLDe MoorPRenaerMde VosPDe RooM.Thyroid function in patients with hyperemesis gravidarum. Amer. J. Obstet, Gynaecol., 1982. 143: 992–926.
7.
CaldwellGKellettHAGowSMBeckettGTSweetingVMSethJToftAD. A new strategy for thyroid function testing. Lancet., 1985. 1: 1117–1119.
8.
SpencerCAEigenAShenD.Duch M, Quails S, Weiss S, Nicoloff J. Specifying of sensitive assays of thyrotropin (TSH) used to screen for thyroid disease in hospitalised patients. Clin. Chem., 1987. 33: 1391–1396.
9.
GowSMKellettHASethJSweetingVMToftADBeckettGJ. Limitations of new thyroid function tests in pregnancy. Clinica. Chimica Acta., 1985. 152: 325–333.
10.
HardistyCAMunroDS. Serum long acting thyroid stimulator protector in pregnancy complicated by Graves' disease. Brit. Med. J., 1983. 286: 934–935.