Journal List > J Korean Soc Endocrinol > v.20(3) > 1063793

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Yoo, Moon, Park, Lee, Jeong, Hong, Oh, Kim, Kim, Yoo, Ihm, Choi, Yoo, Park, and Min: A Case of Hashimoto's Thyroiditis with Transient T3-Thyrotoxicosis Induced by Hydatidiform Mole
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(3): 294-298.

Published online: 30 June 2005

DOI: https://doi.org/10.3803/jkes.2005.20.3.294

A Case of Hashimoto's Thyroiditis with Transient T3-Thyrotoxicosis Induced by Hydatidiform Mole

Ji Youn Yoo, Hong Ju Moon, Cheol Young Park, Seong Jin Lee, In Kyung Jeong, Eun Gyung Hong, Gi Weon Oh, Hyeon Kyu Kim, Doo Men Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, Soo Kee Min

Department of lnternal Medicine and Pathology, College of Medicine, Hallym University, Chunchon, Korea.

Received 15 March 2004       Accepted 8 April 2005

Copyright © 2005 Korean Endocrine Society

Abstract

Human chorionic gonadotropin (HCG) is a member of the glycoproteins family synthesized by the placenta, which consists of 2 noncovalently joined subunits (alpha(α) and beta(β)). The α- and β-subunits have a structural homology with the α- and β-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so β-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic disease (GTD), such as a hydatidiform mole or a choriocarcinoma, but the clinical symptoms of hyperthyroidism are rarely observed. We experienced a case of Hashimoto's thyroiditis, where the patient was diagnosed with T3-thyrotoxicosis, which had initially been induced by excess β-HCG due to an H-mole; after evacuation of the H-mole, the condition was diagnosed as hypothyroidism.
It has been speculated that a patient with Hashimoto's thyroiditis could have hyperthyroidism, induced by β-HCG, due to an H-mole.

Keywords: Hashimoto's thyroiditis, T3-thyrotoxicosis, Hyperthyroidism, GTD (Gestational trophoblastic disease), H-mole

Figures and Tables

Fig. 1
Pelvis MRI shows uterus enlargement (11×8×12 cm) and tiny cystic mass was filled in uterine cavity. The mass shows T1 low-T2 bright signal intensity and mesh-like enhancement.
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Fig. 2
Microscopic findings of endometrium shows hyperplastic trophoblasts on edematous enlarged villi (H&E, ×40)
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Fig. 3
Time course of serum thyroid hormone, TSH and β-HCG
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Fig. 4
Thyroid aspiration cytology shows some follicular cells showing small sized nuclei with smooth membrane and abundant cytoplasm. Many lymphocytes are scattered (Pap, ×200)
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