Clinical characteristics and thyroid function in complete hydatidiform mole complicated by hyperthyroidism

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Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorHarvard Medical School-
Autor(es): dc.contributorBrigham and Women's Hospital-
Autor(es): dc.contributorFluminense Federal University-
Autor(es): dc.creatorRamos, Marcos Montanha-
Autor(es): dc.creatorMaesta, Izildinha-
Autor(es): dc.creatorde Araújo Costa, Roberto Antonio-
Autor(es): dc.creatorMazeto, Glaucia M.F.S.-
Autor(es): dc.creatorHorowitz, Neil S.-
Autor(es): dc.creatorElias, Kevin M.-
Autor(es): dc.creatorBraga, Antonio-
Autor(es): dc.creatorBerkowitz, Ross S.-
Data de aceite: dc.date.accessioned2025-08-21T19:42:25Z-
Data de disponibilização: dc.date.available2025-08-21T19:42:25Z-
Data de envio: dc.date.issued2022-04-29-
Data de envio: dc.date.issued2022-04-29-
Data de envio: dc.date.issued2021-12-31-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1016/j.ygyno.2022.01.037-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/230365-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/230365-
Descrição: dc.descriptionObjectives: To identify possible clinical factors associated with hyperthyroidism at presentation and to assess post-evacuation thyroid function in women with complete hydatidiform mole (CHM). Methods: This observational study included women with CHM attending a specialized Brazilian center in 2002–2018. Clinical and laboratory data (serum hCG, TSH, fT4) were collected at presentation. Factors associated with hyperthyroidism were assessed by logistic regression. Receiver-operating characteristic curves were built to determine the hCG cutoff for predicting hyperthyroidism at CHM presentation. Post-molar evacuation follow-up included clinical assessment and close thyroid function monitoring. Results: Of 137 CHM patients, 69 (50.3%) had hyperthyroidism of any type (43.5% subclinical, 56.5% overt) at presentation. Uterine fundal height > 16 cm or > gestational age (GA), and theca lutein cysts >6 cm were significantly associated with both subclinical and overt hyperthyroidism. The optimal hCG cutoff for predicting hyperthyroidism was 430,559 IU/L (sensitivity 85.5%, specificity 83.8%). Post-evacuation hyperthyroidism/transient hypothyroidism conversion was observed in 13% of the women with hyperthyroidism at presentation. Among the patients not showing conversion to hypothyroidism, median time for TSH normalization was 2 and 3 weeks for subclinical and overt hyperthyroidism, respectively. In the women with overt hyperthyroidism, fT4 was normalized at 2 weeks. Conclusions: Uterine fundal height > 16 cm, uterine fundal height > GA, theca lutein cysts >6 cm, and hCG >400,000 IU/L at presentation are associated with greater risk of hyperthyroidism and its complications. Close monitoring thyroid function during postmolar follow-up showed that, as thyroid hormones are normalized within 2–3 weeks post-evacuation, the use of beta-blockers or antithyroid drugs can be rapidly discontinued.-
Descrição: dc.descriptionPostgraduation Program in Tocoginecology Botucatu Medical School UNESP-São Paulo State University, SP-
Descrição: dc.descriptionBotucatu Trophoblastic Disease Center Clinical Hospital of Botucatu Medical School Department of Gynecology and Obstetrics UNESP-São Paulo State University, SP-
Descrição: dc.descriptionClinical Hospital of Botucatu Medical School Department of Gynecology and Obstetrics UNESP-São Paulo State University, SP-
Descrição: dc.descriptionEndocrinology Clinic Department of Internal Medicine Botucatu Medical School UNESP-São Paulo State University, SP-
Descrição: dc.descriptionNew England Trophoblastic Disease Center Division of Gynecologic Oncology Department of Obstetrics Gynecology and Reproductive Biology Brigham and Women's Hospital Harvard Medical School-
Descrição: dc.descriptionDepartment of Obstetrics and Gynecology Division of Gynecologic Oncology Brigham and Women's Hospital-
Descrição: dc.descriptionRio de Janeiro Trophoblastic Disease Center Maternity School of Rio de Janeiro Federal University Antonio Pedro University Hospital Fluminense Federal University, RJ-
Descrição: dc.descriptionPostgraduation Program in Tocoginecology Botucatu Medical School UNESP-São Paulo State University, SP-
Descrição: dc.descriptionBotucatu Trophoblastic Disease Center Clinical Hospital of Botucatu Medical School Department of Gynecology and Obstetrics UNESP-São Paulo State University, SP-
Descrição: dc.descriptionClinical Hospital of Botucatu Medical School Department of Gynecology and Obstetrics UNESP-São Paulo State University, SP-
Descrição: dc.descriptionEndocrinology Clinic Department of Internal Medicine Botucatu Medical School UNESP-São Paulo State University, SP-
Idioma: dc.languageen-
Relação: dc.relationGynecologic Oncology-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectHuman chorionic gonadotropin-
Palavras-chave: dc.subjectHydatidiform mole-
Palavras-chave: dc.subjectHyperthyroidism-
Palavras-chave: dc.subjectThyroid function-
Palavras-chave: dc.subjectThyrotoxicosis-
Título: dc.titleClinical characteristics and thyroid function in complete hydatidiform mole complicated by hyperthyroidism-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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