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.
Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey.
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Leylek
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Cetin
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Toyaksi
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Erselcan
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