Transient Hyperthyroidism of Hyperemesis Gravidarum: A Case Report from Rural Kenya

Abstract

Purpose: The aim of the study was to assess the transient hyperthyroidism of hyperemesis gravidarum: A case report from rural Kenya.
 Materials and Methods: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
 Findings: Hyperthyroidism complicates 0.2-0.4% of pregnancies. It may be diagnosed in the setting of hyperemesis gravidarum and can be pathological or transient. Untreated pathological hyperthyroidism has adverse maternal and fetal outcomes. Transient hyperthyroidism of hyperemesis gravidarum (THHG) affects up to 60% of women with hyperemesis, is self-limiting, and needs no antithyroid drug treatment. A diagnosis of THHG (rather than overt pathological hyperthyroidism) should be made when hyperthyroidism occurs in the setting of hyperemesis gravidarum and in the absence of pre-pregnancy hyperthyroidism, clinical findings compatible with maternal hyperthyroidism, and a negative antithyroid autoimmune profile. THHG resolves by the end of the first trimester without adverse pregnancy outcomes. We present a case from a rural Kenyan hospital to highlight the clinical profile and management of THHG for the primary care physician.
 Implications to Theory, Practice and Policy: Assessment of thyroid functions is indicated in hyperemesis gravidarum, where there are clinical features of hyperthyroidism. THHG is a self-limiting benign condition that may inappropriately lead to unnecessary drug treatment for pathological hyperthyroidism in pregnancy. A diagnosis of THHG should be made when a laboratory picture of hyperthyroidism occurs in the setting of hyperemesis gravidarum in the absence of pre-pregnancy hyperthyroidism, compatible physical findings, and a negative antithyroid autoantibody profile.