RESUMEN
Serum and urine steroids were examined in two subjects with trophoblastic disease accompanied by large ovarian theca-lutein cysts and compared with those from 10 patients with trophoblastic disease but without palpable cysts. In the patients without cysts normal values were obtained for serum oestradiol, progesterone, 17 alpha-hydroxyprogesterone and androstenedione, and for urinary total oestrogens, pregnanediol, pregnanetriol, and 17-oxosteroids. Nineteen urinary steroid metabolites, quantified by capillary gas-liquid chromatography, were either within reference limits or marginally raised. In several cases relatively minor increases in serum testosterone and cortisol and urinary free cortisol were observed. In contrast, the subjects with cysts showed pronounced excesses of androgen metabolites, 17 alpha-hydroxypregnenolone, pregnanediol, and pregnanetriol, and both exhibited a similar pattern of unusual additional metabolites. The profiles superficially resembled those seen in 21-hydroxylase deficiency adrenogenital syndrome, but there were important discrepancies reflecting known differences in ovarian and adrenal steroid metabolism. Chemotherapy led to decline of human chorionic gonadotrophin concentrations, regression of the cysts, and return to normal of the steroid profile. Excess steroids in the patients with cysts may have originated in the ovary rather than in the trophoblastic tissue.
Asunto(s)
Quistes Ováricos/metabolismo , Esteroides/metabolismo , Neoplasias Trofoblásticas/metabolismo , Neoplasias Uterinas/metabolismo , Adulto , Cromatografía de Gases , Femenino , Humanos , Masculino , Quistes Ováricos/complicaciones , Embarazo , Pregnanodiol/metabolismo , Pregnanotriol/metabolismo , Pregnanolona/análogos & derivados , Pregnanolona/metabolismo , Neoplasias Trofoblásticas/complicaciones , Neoplasias Uterinas/complicacionesAsunto(s)
Bilirrubina/metabolismo , Ácidos Grasos no Esterificados/farmacología , Ictericia Neonatal/etiología , Hígado/metabolismo , Animales , Cromatografía en Capa Delgada , Glucuronatos/metabolismo , Humanos , Técnicas In Vitro , Recién Nacido , Hígado/efectos de los fármacos , Leche Humana , RatasAsunto(s)
Lactógeno Placentario/sangre , Computadores , Femenino , Humanos , Matemática , Embarazo , Radioinmunoensayo/métodos , Análisis de RegresiónRESUMEN
Human chorionic gonadotrophin (hCG) levels and thyroid function were monitored in 44 patients receiving chemotherapy for treatment of trophoblastic disease. We observed a strong correlation between hCG and thyroid stimulating hormone (TSH) concentrations measured by radioimmunoassay, and this appears to be due to cross-reactivity between hCG and the anti-TSH antibody used. The concentration of thyroid hormones was little affected by the raised levels of TSH or hCG, except when the concentration of the latter rose to high levels, usually above 100,000 i.u./l. The possible mechanisms of thyroid homeostasis in trophoblastic disease are considered.