Utilisation of gonadotrophin-releasing hormone (GnRH) analogue to differentiate ovarian from adrenal hyperandrogenism in postmenopausal women
| العنوان: | Utilisation of gonadotrophin-releasing hormone (GnRH) analogue to differentiate ovarian from adrenal hyperandrogenism in postmenopausal women |
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| المؤلفون: | M J Brassill, E Bahaeldein |
| المصدر: | Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-5 (2018) Endocrinology, Diabetes & Metabolism Case Reports |
| بيانات النشر: | Bioscientifica, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | endocrine system, lcsh:RC648-665, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Hyperthecosis, Hyperandrogenism, Oophorectomy, Physiology, 030209 endocrinology & metabolism, Leydig cell tumour, medicine.disease, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Novel Diagnostic Procedure, Leuprorelin, 030220 oncology & carcinogenesis, Internal Medicine, medicine, business, Testosterone, hirsutism, medicine.drug, Hormone |
| الوصف: | Summary Postmenopausal hyperandrogenism is a relatively rare diagnosis resulting from excess androgen production from the adrenals or ovaries. The exclusion of malignant causes is a priority. Laboratory tests and imaging are utilised to help differentiate the source of excess androgens. We report two cases of postmenopausal hyperandrogenism in women aged 75 and 67 years. Both cases presented with clinical features suggestive of hyperandrogenism which had developed gradually over the previous 2 years. Laboratory investigations confirmed a significant elevation in their serum testosterone levels. In both cases, imaging did not reveal any abnormality of the adrenals or ovaries. To help differentiate an adrenal vs ovarian source a single-dose GnRH analogue was given with measurement of testosterone and gonadotrophin levels pre and post. The reduction in gonadotrophins achieved by the GnRH analogue resulted in suppression of testosterone levels which suggested an ovarian source. Both patients proceeded to bilateral oophorectomy. Histology revealed a benign hilus cell tumour in one case and a benign Leydig cell tumour in the other. Learning points: A key part of the work-up of postmenopausal hyperandrogenism is to differentiate between an adrenal or an ovarian source of excess androgens; Imaging may not identify small ovarian tumours or hyperthecosis and may also identify incidental adrenal masses which are non-functioning; Current guidelines suggest ovarian and adrenal venous sampling when imaging is inconclusive but this requires technical expertise and has a high failure rate; GnRH analogue use can successfully confirm ovarian source and should be considered as a diagnostic tool in this setting. |
| اللغة: | English |
| تدمد: | 2052-0573 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c35cc6aebe643296c76bb229dc1c0cdTest https://edm.bioscientifica.com/view/journals/edm/2018/1/EDM18-0084.xmlTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8c35cc6aebe643296c76bb229dc1c0cd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20520573 |
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