Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]
Klinik tirotoksikoz molar gebeliğin nadir görülen komplikasyonlarından biridir. Mol hidatiformda hipertiroidi ile ilişkili semptomların sebebi; yüksek konsantrasyonlardaki β-hCG'nin tirotropik etkisidir. HCG molekülü α ve β subünitelerinden meydana gelir. α subunitesi TSH\'a birebir benzerken β subunitesi kısmi olarak benzer. Bu olgu sunumunda yeterli açlık süresi sağlanamayan dilatasyonal küretaj planlanan tiroid krizindeki mol hidatiformlu hastaya anestezik yaklaşımın tartışılması amaçlandı.
Anahtar Kelimeler:
Mol hidatiform, hipertiroidizm, anestezi
Molar gebeliğin tetiklediği tiroid krizinde anestezik yaklaşım [Anesthetic management in thyroid crisis triggered by molar pregnancy]
Clinical thyrotoxicosis is one of the rare complications of molar pregnancy. The cause of the symptoms associated with hyperthyroidism in mol hydatiform is the thyrotrophic effects of high levels of β-hCG. The hCG molecule consists of α and β subunits; the α subunit is identical to TSH and the β subunit has a similar structure to TSH. In this case report it was aimed to discuss the anesthetic management of a dilatation and curettage case in a patient with mol hydatiform and thyroid crisis.
Keywords:
Hydatidiform mole, hyperthyroidism, anesthesia,
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- Ozalp SS, Yalcin OT, Tanır HM. Hydatidiform mole in Turkey from 1932-2000. Int J Gynecol Obstet 2001;73 (3):257-8.
- Berkowitz R S, Goldstein D P, DuBeshter B, Bernstein MR. Management of complete molar pregnancy. J Reprod Med 1987; 32 (9): 634-9.
- Itzkowic D. Hydatidiform mole and thyrotoxicosis. A case re- port. Br J Obstet Gynaecol 1976; 83 (1): 86-9.
- Hershman JM, Higgins HP. Hydatidiform mole: a cause of clini- cal hyperthyroidism. N Engl J Med 1971; 284 (11): 573-7.
- Rajatanavin R, Chailurkit LO, Srisupandit S, Tungtrakul S, Bunyaratvej S. Trophoblastic hyperthyroidism: clinical and biochemical features of fi ve cases. Am J Med 1988;85 (2) :237-41.
- Kenimer JG, Hershman JM, Higgins HP. The thyrotropin in hydatidiform moles is human chorionic gonadotropin. J Clin Endocrinol Metab 1975;40 (3) :482-91.
- Hershman JM. Hyperthyroidism induced by trophoblastic thy- rotropin. Mayo Clin Proc 1972;47 (12) :913-8.
- Narasimhan KL, Ghobrial MW, Ruby EB. Hyperthyroidism in the setting of gestational trophoblastic disease. Am J Med Sci 2002;323(5):285-7.
- Sowers JR, Hershman JM, Carlson HE, Pekary AE. Effect of human chorionic gonadotropin on thyroid function in euthy- roid men. J Clin Endocrinol Metab 1978;47(4):898-901.
- Tomer Y, Huber GK, Davies TF. Human chorionic gonado- tropin (hCG) interacts directly with recombinant human TSH receptors. J Clin Endocrinol Metab 1992;74 (6):1477-9.
- Matsumoto S, Shingu C, Hidaka S, et al. Anesthetic manage- ment of a patient with hyperthyroidism due to hydatidiform mole. J Anesth 2009;23(4):594-6.
- Erturk E, Bostan H, Geze S, Saracoglu S, Erciyes N, Eroglu A. Total intravenous anesthesia for evacuation of a hydatidi- form mole and termination of pregnancy in a patient with thy- rotoxicosis. Int J Obstet Anesth 2007;16 (4):363-6.
- Solak M, Aktürk G. Spinal anesthesia in a patient with hyper- thyroidism due to hydatidiform mole. Anesth Analg 1993;77 (4): 851-2.
- Başlangıç: 2010
- Yayıncı: Sağlık Araştırmaları Derneği
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