transient non-autoimmune hyperthyroidism of early pregnancy怀孕早期的瞬态non-autoimmune甲状腺机能亢进.pdf

SAGE-Hindawi Access to Research Journal of Thyroid Research Volume 2011, Article ID 142413, 11 pages doi:10.4061/2011/142413 Research Article Transient Non-Autoimmune Hyperthyroidism of Early Pregnancy Alexander M. Goldman and Jorge H. Mestman Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA Correspondence should be addressed to Jorge H. Mestman, mestman@ Received 22 March 2011; Revised 4 May 2011; Accepted 4 May 2011 Academic Editor: Roberto Negro Copyright © 2011 A. M. Goldman and J. H. Mestman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. It is characterized by chemical and sometimes clinical hyperthyroidism, without evidence of thyroid autoimmunity that resolves spontaneously by 16 weeks gestation without significant obstetrical complications. 1. Introduction a “low serum TSH” in the first trimester of gestation should be considered “physiologic” in the presence of normal se- Common Presentation. 26 y/o women, G1, P0, at 8 weeks ges- rum-free thyroxine (FT4) value. The exception could be a tation presents to the physician with a 3 weeks history of nau- woman with T3 hyperthyroidism due to an autonomous sea and vomiting, weight loss of 2 kg., unable to tolerate solid or “hot” thyroid nodule. Thyroid tests in the hyperthyroid foods, mild hands tremor, and palpitations with a pulse rate range may be seen in the first trimester of pregnancy in of 104 beats per minute. Serum TSH 0.02 mIU/