以甲状腺功能亢进为首发表现的葡萄胎1例

A case of complete hydatidiform mole presenting as hyperthyroidism

葡萄胎(HM)是一种异常的人类妊娠,可将其分为完全性葡萄胎(CHM)和部分性葡萄胎(PHM)。其主要临床表现为停经后阴道不规则流血、子宫异常增大、妊娠呕吐、腹痛、卵巢黄素化囊肿及甲状腺功能亢进征象等,其中甲状腺功能亢进临床表现少见。我们报道1例以间断性怕热、多汗、心悸、消瘦为主要临床表现的育龄期女性患者,常规抗甲状腺药物治疗无效,后经阴道B超、血HCG检查诊为CHM。清宫术后患者临床症状好转,甲状腺功能完全恢复正常,从而证实甲状腺功能亢进继发于CHM。因此,临床医生对于育龄期女性甲状腺功能亢进患者,在排除甲状腺性、垂体性以及医源性因素后,应注意葡萄胎及其他妊娠滋养细胞疾病等妇科情况及疾病。

Hydatidiform mole（HM） is an abnormal human pregnancy, and can be divided into complete hydatidiform mole（CHM） and partial hydatidiform mole（PHM）.Its main clinical manifestations are postmenopausal vaginal irregular bleeding, abnormal enlargement of uterine, hyperemesis gravidarum, development of theca lutein ovarian cysts and hyperthyroidism,et al, of which hyperthyroidism is uncommon. Here we reported a childbearing age female patient presenting as fear heat, hidrosis, palpitation, marasmus, but conventional treatment of anti-thyroid drugs was ineffective, and finally diagnosed of CHM through the scan of transvaginal ultrasound B and serum human chorionic gonadotropin（HCG）.After curettage, the clinical symptoms of the patient improved and the thyroid function returned to normal, confirming hyperthyroidism was secondary to CttM. HM and the other gestational trophoblastic disease should be considered in all childbearing age female patients with hyperthyroidism and no evidence of thyroid, pituitary and iatrogenic factors.