A Case Report of Impending Thyroid Storm and Pemphigoid Gestationis Complicating Complete Molar Pregnancy

Gestational trophoblastic disease, very rarely, is complicated by thyroid storm and pemphigoid gestationis. Thyroid storm is related to human chorionic gonadotropin hormone levels produced in pregnancy, but is usually exaggerated in molar pregnancies. With thyroid storm presenting acutely with cardiovascular and gastrointestinal collapse and pemphigoid gestationis manifesting as an intense, blistering, pruritic dermatosis, it is critical to recognise early the signs and symptoms to avert complications from these rare phenomena. We present a 24-year-old female who was referred with amenorrhoea of three months' duration with persistent vomiting, diarrhoea, and palpitations. She spontaneously expelled huge vesicular moles and subsequently developed pemphigoid gestationis. Skin biopsy showed focal spongiosis with subepidermal bullae and an admixture of eosinophils and neutrophils extending deep into the dermis with associated hyperkeratosis as well as intraepidermal blood-filled bullae. She was managed by a multidisciplinary team with prompt action to prevent deterioration.