title: Extended hyperemesis gravidarum in a patient after total thyroidectomy.
abstract: BACKGROUND
  Human chorionic gonadotropin is regarded as, at least, one of the main factors responsible for hyperemesis gravidarum by direct stimulation of the thyroid gland on the basis of a close homology to the structure of TSH. However, questions to this theory of hCG-induced gestational hyperthyroidism still remain.
  
  
  METHODS
  We present for the first time a rare case of hyperemesis gravidarum in a patient with a previous removed thyroid gland and an adequate thyroxin replacement. In this case report we present an extended hyperemesis gravidarum in a patient after total thyroidectomy and thus artificially well-set thyroid parameters.
  
  
  CONCLUSIONS
  Although transient hyperthyroidism is widely thought to be causative of a hyperemesis during pregnancy, this case report with a mildly hypothyroidism emphasizes that there might be other, yet unknown, factors that can cause such a severe complication.
authors.affiliation: First Department of Obstetrics and Gynaecology, Ludwig-Maximilians University Munich, Germany.
authors.forename: T J F
authors.initials: TJ
authors.lastname: Blankenstein
authors.forename: F
authors.initials: F
authors.lastname: Kainer
authors.forename: K
authors.initials: K
authors.lastname: Friese
authors.forename: I
authors.initials: I
authors.lastname: Mylonas