title: Hyperemesis gravidarum presenting as jaundice and transient hyperthyroidism complicated with acute pancreatitis.
abstract: Hyperemesis gravidarum is an extreme form of nausea and vomiting during pregnancy. Its presenting symptoms include vomiting, disturbed nutrition, electrolyte imbalance, ketosis, extreme weight loss, renal and/or liver damage. It is rare for a hyperemesis gravidarum patient to present with jaundice, hyperthyroidism and idiopathic acute pancreatitis during the same hospitalization period. Here, we report such a case. A 25-year-old pregnant woman without underlying liver or thyroid disease was admitted due to jaundice noted for 2 days at 8 weeks of gestational age. Hyperthyroidism symptoms of tachycardia and finger tremor also bothered her. After treatment with parenteral fluid and antithyroid agents, her clinical condition improved. However, an episode of idiopathic pancreatitis occurred after nausea and vomiting subsided. Bowel rest with parenteral fluid and nutrition supplement was given and the increased pancreatic enzyme level gradually subsided. Follow-up liver and thyroid function were normal after gestational age of 26 weeks. She delivered a healthy female baby without low birth body weight at gestational age of 39 weeks. Rapid diagnosis and supportive care are important for the hyperemesis gravidarum patient with the complication of acute pancreatitis.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Meng Tzu
authors.initials: MT
authors.lastname: Weng
authors.forename: Shu Chen
authors.initials: SC
authors.lastname: Wei
authors.forename: Jau Min
authors.initials: JM
authors.lastname: Wong
authors.forename: Tien Chun
authors.initials: TC
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications* / Q000175:diagnosis; D006980:Hyperthyroidism / Q000150:complications* / Q000175:diagnosis; D007565:Jaundice / Q000150:complications* / Q000175:diagnosis; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome