From Molar Pregnancy, Thyrotoxicosis, to Pulmonary Hypertension: A Case Report

Abstract

Background: Molar pregnancy is a benign condition with the dominant symptom being dark brown to bright red bleeding from the vagina. This disease can induce hyperthyroidism and result in pulmonary hypertension. This case report describes a patient who had molar pregnancy with thyrotoxicosis and pulmonary hypertension.Case: A 30-year-old woman presented with complaints of lower abdominal pain for the last month. The patient feels that her stomach has enlarged in the last 3 months. Other complaints include bleeding and observed bubbles from the birth canal, shortness of breath, and chest pain. The serum cobas β-hCG level of 7954.00 mIU/mL. On abdominal ultrasound examination, vesicles formed a honeycomb appearance, measuring 7.4 cm×5.3 cm. Hematologic laboratory tests revealed low TSH levels (<0.01 μIU/mL), T3 levels of 2.35 ng/ml, and FT4 levels of 2.62 ng/dL. The results of the echocardiography examination showed there is a high probability of pulmonary hypertension.Conclusion: Molar pregnancy can exacerbate thyrotoxicosis through hCG activity. Smoking and breastfeeding also have similar effects. Consequently, increased thyroid hormone levels can worsen or cause pulmonary hypertension.