The clinical diversity of primary hypothyroidism presenting as a spontaneous ovarian hyperstimulation syndrome.

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM Endocrinology, Diabetes and Metabolism Case Reports Pub Date : 2024-09-27 Print Date: 2024-07-01 DOI:10.1530/EDM-23-0084
Krishna Prabha, K Felix Jebasingh, Vaibhav Londhe, Nihal Thomas
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Abstract

Summary: Ovarian hyperstimulation syndrome (OHSS) usually occurs in patients undergoing assisted reproduction techniques and ovulation induction. Its variant, spontaneous ovarian hyperstimulation syndrome, a potentially life-threatening disorder, is uncommon and only a few cases have been reported in association with hypothyroidism. This study analysed five patients with untreated chronic hypothyroidism presenting with multicystic ovaries, isosexual precocious puberty, and delayed bone age; subsequently, the follow-up and regression of ovarian pathology was assessed. Two patients had presented to the emergency department with menorrhagia and hypotension, of these, one had ovarian torsion at presentation. Three patients presented to the outpatient department: one for evaluation of short stature, one for premature menarche, and another with polycystic ovaries. They were all diagnosed with long-standing, untreated chronic hypothyroidism. There was regression of the size of the cystic ovaries on subsequent follow-up. In all these patients, long-standing hypothyroidism had resulted in ovarian hyperstimulation syndrome. The potentially life-threatening complications of this syndrome may be prevented by careful screening and a strong index of clinical suspicion at the outset.

Learning points: Long-standing, untreated primary hypothyroidism may result in spontaneous ovarian hyperstimulation syndrome. A high index of suspicion is required for an early and accurate diagnosis. The requirement for interdepartmental collaboration between gynaecology and endocrinology departments is essential for the successful management of this life-threatening but easily treatable disorder.

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原发性甲状腺功能减退症表现为自发性卵巢过度刺激综合征的临床多样性。
摘要:卵巢过度刺激综合征(OHSS)通常发生在接受辅助生殖技术和促排卵的患者身上。其变异体--自发性卵巢过度刺激综合征是一种可能危及生命的疾病,但并不常见,仅有少数病例报告与甲状腺功能减退症有关。本研究分析了五例未经治疗的慢性甲状腺功能减退症患者,这些患者均伴有多囊卵巢、异性性早熟和骨龄延迟;随后,研究人员对患者的随访情况和卵巢病理变化的消退情况进行了评估。两名患者因月经过多和低血压到急诊科就诊,其中一人在就诊时卵巢扭转。三名患者到门诊部就诊:一名因身材矮小,一名因月经初潮过早,另一名因多囊卵巢就诊。他们都被诊断为长期未治疗的慢性甲状腺功能减退症。在随后的随访中,囊性卵巢的大小有所减小。在所有这些患者中,长期的甲状腺机能减退导致了卵巢过度刺激综合征。通过仔细筛查,并在一开始就对其进行严格的临床怀疑,可以避免该综合征潜在的危及生命的并发症:学习要点:长期未治疗的原发性甲状腺功能减退症可能导致自发性卵巢过度刺激综合征。要想及早做出准确诊断,需要高度怀疑。妇科和内分泌科之间的跨部门合作对于成功治疗这种危及生命但易于治疗的疾病至关重要。
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来源期刊
CiteScore
1.50
自引率
0.00%
发文量
142
审稿时长
9 weeks
期刊介绍: Endocrinology, Diabetes & Metabolism Case Reports publishes case reports on common and rare conditions in all areas of clinical endocrinology, diabetes and metabolism. Articles should include clear learning points which readers can use to inform medical education or clinical practice. The types of cases of interest to Endocrinology, Diabetes & Metabolism Case Reports include: -Insight into disease pathogenesis or mechanism of therapy - Novel diagnostic procedure - Novel treatment - Unique/unexpected symptoms or presentations of a disease - New disease or syndrome: presentations/diagnosis/management - Unusual effects of medical treatment - Error in diagnosis/pitfalls and caveats
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