HYPERTHYRODISM IN GESTATIONAL TROPHOBLASTIC NEOPLASIA

The thyroid status of 27 African patients with gestational trophoblastic neoplasia (GTN) was studied. Fifteen patients were biochemically hyperthyroid (8 patients with choriocarcinoma; 7 with hydatidiform mole). Of these 15 patients, 9 were clinically thyrotoxic. The most serious complication of thyrotoxicosis was life-threatening acute pulmonary edema with associated cardiac failure. When serum levels of the human chorionic gonadotropin (hCG) reached a level of about 0.1 .times. 106 IU/1, 13 of 16 patients were biochemically hyperthyroid; at serum levels of 0.3 .times. 106 IU/l of hCG most patients were clinically thyrotoxic. A feature of hyperthyroidism associated with GTN is that whereas T4 [thyroxine] is invariably raised, the T3[triiodothyronine]:T4 ratio tends to be low (0.015 .+-. 005); r[reverse]T3:T3 ratios were high in this group. TSH levels were not increased.