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Research Article Free access | 10.1172/JCI106614

Alterations in thyroid hormone economy in patients with hydatidiform mole

Valerie Anne Galton, Sidney H. Ingbar, Jesus Jimenez-Fonseca, and Jerome M. Hershman

Department of Physiology, Dartmouth Medical School, Hanover, New Hampshire

Thorndike Memorial Laboratory and the Harvard Medical Services, Boston City Hospital, Boston, Massachusetts 02118

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02118

Hospital de Gineco-Obstetricia numero dos, Centro Medico Nacional, Mexico 7, D. F., Mexico

Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35233

Find articles by Galton, V. in: PubMed | Google Scholar

Department of Physiology, Dartmouth Medical School, Hanover, New Hampshire

Thorndike Memorial Laboratory and the Harvard Medical Services, Boston City Hospital, Boston, Massachusetts 02118

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02118

Hospital de Gineco-Obstetricia numero dos, Centro Medico Nacional, Mexico 7, D. F., Mexico

Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35233

Find articles by Ingbar, S. in: PubMed | Google Scholar

Department of Physiology, Dartmouth Medical School, Hanover, New Hampshire

Thorndike Memorial Laboratory and the Harvard Medical Services, Boston City Hospital, Boston, Massachusetts 02118

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02118

Hospital de Gineco-Obstetricia numero dos, Centro Medico Nacional, Mexico 7, D. F., Mexico

Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35233

Find articles by Jimenez-Fonseca, J. in: PubMed | Google Scholar

Department of Physiology, Dartmouth Medical School, Hanover, New Hampshire

Thorndike Memorial Laboratory and the Harvard Medical Services, Boston City Hospital, Boston, Massachusetts 02118

Department of Medicine, Harvard Medical School, Boston, Massachusetts 02118

Hospital de Gineco-Obstetricia numero dos, Centro Medico Nacional, Mexico 7, D. F., Mexico

Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35233

Find articles by Hershman, J. in: PubMed | Google Scholar

Published June 1, 1971 - More info

Published in Volume 50, Issue 6 on June 1, 1971
J Clin Invest. 1971;50(6):1345–1354. https://doi.org/10.1172/JCI106614.
© 1971 The American Society for Clinical Investigation
Published June 1, 1971 - Version history
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Abstract

Studies of several aspects of thyroid hormone economy have been conducted in 11 patients before and after removal of a molar pregnancy. Before evacuation of the mole, all patients demonstrated moderately to greatly elevated values for thyroidal 131I uptake, absolute iodine uptake, and serum protein-bound-131I. Values for serum PBI and serum thyroxine (T4) concentration were consistently and often greatly increased, averaging more than twice those found in normal pregnancy and three times those in normal controls. On the other hand, the maximum binding capacity of the T4-binding globulin (TBG) was variably affected, and ranged between the values found in normal controls and those found in normal pregnancy. Values for the absolute concentration of free T4 in serum were, on the average, only moderately elevated, since the proportion of free T4 was moderately low, although not as low as in normal pregnancy. Sera of patients with molar pregnancy contained high levels of thyroid stimulating activity, as assessed in the McKenzie mouse bioassay system. The stimulator displayed a more prolonged duration of action than that of TSH and did not reveal a major immunological cross-reactivity with either human or bovine TSH, differing in the latter respect from the chorionic thyrotropin of normal human placenta. Abnormalities in iodine metabolism were rapidly ameliorated after removal of the molar pregnancy, and this was associated with the disappearance from serum of the thyroid stimulator.

Despite the foregoing evidence of thyroid hyperfunction and hypersecretion of T4, patients with molar pregnancy were neither goitrous nor overtly thyrotoxic. They did display, however, high values of the urinary pigment/creatinine ratio, a possible indication of the presence of a hypermetabolic state.

It is concluded that in patients with molar pregnancy, thyroid function and T4 secretion are stimulated, often greatly so, by an unusual thyroid stimulator which is demonstrable in the blood and which is probably of molar origin. The nature of the stimulator, as well as the reasons for both the variability of the increase in TBG which occurs in molar pregnancy and the lack of frank thyrotoxicosis, remain to be clarified.

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