Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole

Pemphigoid gestationis (PG) is a rare, perinatal, autoimmune, and blistering dermatosis. Only few cases of PG involving hydatidiform moles have been reported. Complete hydatidiform moles are usually evacuated by dilatation and curettage. We report a patient with a massive complete hydatidiform mole...

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Main Authors: Naoki Matsumoto, Marie Osada, Kou Kaneko, Ken Ohara, Daito Noguchi, Haruhiko Udagawa, Nagazumi Suzuki, Chieko Matsumoto, Sachio Takahashi
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2013/267268
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author Naoki Matsumoto
Marie Osada
Kou Kaneko
Ken Ohara
Daito Noguchi
Haruhiko Udagawa
Nagazumi Suzuki
Chieko Matsumoto
Sachio Takahashi
author_facet Naoki Matsumoto
Marie Osada
Kou Kaneko
Ken Ohara
Daito Noguchi
Haruhiko Udagawa
Nagazumi Suzuki
Chieko Matsumoto
Sachio Takahashi
author_sort Naoki Matsumoto
collection DOAJ
description Pemphigoid gestationis (PG) is a rare, perinatal, autoimmune, and blistering dermatosis. Only few cases of PG involving hydatidiform moles have been reported. Complete hydatidiform moles are usually evacuated by dilatation and curettage. We report a patient with a massive complete hydatidiform mole that underwent spontaneous expulsion; she subsequently developed PG. A 19-year-old unmarried nulligravid woman was referred to our hospital following excessive vaginal bleeding after an uncertain amenorrheal period. The patient presented with preshock vital signs, severe anemia, and a positive urine pregnancy test. Imaging examinations revealed a massive intrauterine mass (19 × 15 × 10 cm), suggesting a complete hydatidiform mole. She was hospitalized and treated with blood transfusion. Sixteen hours after hospitalization, the massive molar mass underwent spontaneous expulsion and bleeding ceased. Three days after the expulsion, she developed pruritic skin lesions including papules, erythemas, and bullae, which spread over her entire body. Skin biopsy revealed PG and subepidermal blister formation and linear complement C3 deposition along the basement membrane zone, and the serum anti-BP180 antibody level was found to be high on measurement. She was effectively treated with 50 mg/day of oral prednisolone. Her skin lesions disappeared, leaving pigmentation.
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spelling doaj-art-c64be2deac8d4abca4802206ed7424b72025-08-20T03:23:22ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922013-01-01201310.1155/2013/267268267268Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform MoleNaoki Matsumoto0Marie Osada1Kou Kaneko2Ken Ohara3Daito Noguchi4Haruhiko Udagawa5Nagazumi Suzuki6Chieko Matsumoto7Sachio Takahashi8Department of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Pathology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama 350-8550, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanDepartment of Obstetrics and Gynecology, Fukaya Red Cross Hospital, 5-8-1 Kamishibachonishi, Fukaya City, Saitama 366-0052, JapanPemphigoid gestationis (PG) is a rare, perinatal, autoimmune, and blistering dermatosis. Only few cases of PG involving hydatidiform moles have been reported. Complete hydatidiform moles are usually evacuated by dilatation and curettage. We report a patient with a massive complete hydatidiform mole that underwent spontaneous expulsion; she subsequently developed PG. A 19-year-old unmarried nulligravid woman was referred to our hospital following excessive vaginal bleeding after an uncertain amenorrheal period. The patient presented with preshock vital signs, severe anemia, and a positive urine pregnancy test. Imaging examinations revealed a massive intrauterine mass (19 × 15 × 10 cm), suggesting a complete hydatidiform mole. She was hospitalized and treated with blood transfusion. Sixteen hours after hospitalization, the massive molar mass underwent spontaneous expulsion and bleeding ceased. Three days after the expulsion, she developed pruritic skin lesions including papules, erythemas, and bullae, which spread over her entire body. Skin biopsy revealed PG and subepidermal blister formation and linear complement C3 deposition along the basement membrane zone, and the serum anti-BP180 antibody level was found to be high on measurement. She was effectively treated with 50 mg/day of oral prednisolone. Her skin lesions disappeared, leaving pigmentation.http://dx.doi.org/10.1155/2013/267268
spellingShingle Naoki Matsumoto
Marie Osada
Kou Kaneko
Ken Ohara
Daito Noguchi
Haruhiko Udagawa
Nagazumi Suzuki
Chieko Matsumoto
Sachio Takahashi
Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
Case Reports in Obstetrics and Gynecology
title Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
title_full Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
title_fullStr Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
title_full_unstemmed Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
title_short Pemphigoid Gestationis after Spontaneous Expulsion of a Massive Complete Hydatidiform Mole
title_sort pemphigoid gestationis after spontaneous expulsion of a massive complete hydatidiform mole
url http://dx.doi.org/10.1155/2013/267268
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