Hyperthyroidism in hyperemesis gravidarum.
OBJECTIVE
To evaluate the hormonal and hematologic parameters of 24 patients with hyperemesis gravidarum without evidence of thyroid disease compared with matched controls.


METHODS
Twenty-four pregnant women with hyperemesis and 20 control subjects were included in this study. A prospective comparison of hormonal milieu of hCG and thyroid function was performed.


RESULTS
Mean serum hCG, fT3, and fT4 levels of patients were significantly higher than those of controls (P < 0.007), while there was no statistically significant difference in terms of TSH. Serum hCG correlated negatively with TSH and positively with fT3 and fT4 in the patient group (r = 0.66, r = 0.70, r = 0.85; P < 0.05, respectively), while there was no relationship between hCG and thyroid functions in controls (r < 0.25). The lymphocyte count of patients was significantly higher than that of controls (P < 0.007), while there were no statistically significant differences in the overall white blood count and the granulocyte count (P > 0.007). The lymphocyte count correlated positively with serum hCG, fT4 and fT3, and negatively with TSH in the patient group (r = 0.73, r = 0.72, r = 0.64 and r = -0.63; P < 0.05, respectively), while there was no relationship between lymphocyte count and serum hCG, fT4, fT3 and TSH in controls (r < 0.25).


CONCLUSIONS
Maternal immune recognition of the conceptus and immune response, hypothetically, may be related to the high level of hCG and/or fT4. Patients who have hyperthyroidism in early pregnancy should be assessed for transient hyperthyroidism as it relates to hyperemesis gravidarum.
Leylek
O A
OA
Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey.
Cetin
A
A
Toyaksi
M
M
Erselcan
T
T
D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000097:blood / Q000150:complications*; D006980:Hyperthyroidism / Q000097:blood / Q000150:complications*; D018655:Lymphocyte Count; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000097:blood
D006063:Chorionic Gonadotropin; D013963:Thyroid Hormones