Stormy Encounter with Partial Hydatidiform Mole

Abstract

We report a case of a 40-year-old multiparous woman who underwent total abdominal hysterectomy due to massive vaginal bleeding from partial molar pregnancy. Post-operatively, she developed high-grade fever, profuse sweating and shortness of breath. Examination revealed tachycardia, hypertension, elevated jugular venous pressure, crackles on both lower lung fields, with no palpable thyroid mass. Free thyroxine (FT4) and human chorionic gonadotropin ß-subunit (ß-hCG) were markedly elevated, while thyroid stimulating hormone (TSH) was significantly suppressed. With a Burch and Wartofsky score of 55, thyroid storm from the molar pregnancy was considered. She was given propylthiouracil (PTU), propranolol and hydrocortisone. Resolution of her signs and symptoms were noted 2 to 3 days following treatment.