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Gestational transient thyrotoxicosis — SCE Endocrinology MCQ

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ModerateThyroidGestational transient thyrotoxicosisSCE Endocrinology

A 26-year-old woman has TSH 0.08 mU/L, free T4 16 pmol/L and free T3 5.1 pmol/L. She is 10 weeks pregnant with severe hyperemesis. TSH receptor antibody is negative and there is no goitre. What is the most likely diagnosis?

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Correct answer: B — Gestational transient thyrotoxicosis

Hyperemesis with mild thyrotoxicosis in early pregnancy and negative TSH receptor antibody suggests hCG-mediated gestational transient thyrotoxicosis. Graves' disease is more likely with goitre, eye signs or positive antibodies. Treatment is usually supportive rather than antithyroid drugs unless clinically severe and persistent.

Reference: NICE NG145; Endocrine Society Pregnancy Thyroid Guidance