Ovarian Hyperstimulation Syndrome and Autoimmune Primary Hypothyroidism in Two Members of a Family

Emami, Mohammad Hassan Hedayati; Langroudi, Roghieh Molaei

doi:10.4172/2165-7920.1000113

Cited by 8 publications

(13 citation statements)

References 23 publications

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“…A description of OHSS in two members of a family has recently been published (3), but there are a few studies focusing on ovarian volume and cyst regression after l -T 4 replacement therapy. Imaging findings in OHSS include multiple, large, and thin-walled cysts and ascitic fluid in severe forms (4).…”

Section: Discussionmentioning

confidence: 99%

“…Hormonal studies confirmed hypothyroidism: serum TSH >100 mIU/l, total T 4 =1.8 μg/dl (normal: 4.4–12.5 μg/dl, radioimmunoassay (RIA)), T3RU=31.2% (normal: 25–34.4%), anti-TPO antibody=290 U/ml (normal <70, ELISA), and prolactin=176 ng/ml (normal: 3–21, RIA) (3). Abdominal and pelvic ultrasound revealed enlarged ovaries that occupied the whole abdomen and pelvic cavity: right ovary, 150×75×62 mm with a volume of 454 cc; left ovary, 130×70×68 mm with a volume of 340 cc.…”

Section: Investigationmentioning

confidence: 97%

“…On examination, she had classical features of hypothyroidism (3). The abdomen was distended and non-tender with a large palpable mass in the lower abdomen extending to the upper abdomen.…”

Section: Case Presentationmentioning

confidence: 99%

“…We have described this syndrome in a girl virgin with primary autoimmune hypothyroidism in our previous article (3); we followed her by serial abdominal ultrasound that showed normal ovary size and regression of ovarian cysts after levothyroxine ( l -T 4 ) replacement.…”

Section: Introductionmentioning

confidence: 99%

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Ovarian cyst regression with levothyroxine in ovarian hyperstimulation syndrome associated with hypothyroidism

Langroudi

Amlashi

Emami

2013

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryBackground: Spontaneous ovarian hyperstimulation syndrome (sOHSS) can occur following hypothyroidism. Ultrasonography facilitates diagnosis and monitoring of this syndrome. We describe ovarian sonographic changes in a hypothyroid patient with sOHSS after treatment with levothyroxine (l-T4).Case presentation: A 15-year-old girl presented with abdominal pain and distension for a few months. On examination, she had classical features of hypothyroidism. Abdominal and pelvic ultrasound revealed enlarged ovaries with multiple thin-walled cysts and mild ascitic fluid. On follow-up, abdominal ultrasound showed significant reduction of ovary size after 6 weeks of initiation of l-T4. Normal ovary size with complete regression of ovarian cysts was seen after 4 months.Conclusion: Serial ultrasound in sOHSS associated with hypothyroidism showed regression of ovarian cysts and ovarian volume after 4 months whereas in other studies, it is reported to happen in various durations, presumably according to its etiology.Learning points OHSS can rarely occur due to hypothyroidism.This type of OHSS can be simply treated by l-T4 replacement, rather than conservative management or surgery in severe cases.Ultrasound follow-up shows significant regression of ovarian size and cysts within 6 weeks of initiation of l-T4.Ultrasound follow-up shows normal ovarian size with complete resolution of ovarian cysts 4 months after treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Investigationmentioning

confidence: 97%

“…On examination, she had classical features of hypothyroidism (3). The abdomen was distended and non-tender with a large palpable mass in the lower abdomen extending to the upper abdomen.…”

Section: Case Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ovarian cyst regression with levothyroxine in ovarian hyperstimulation syndrome associated with hypothyroidism

Langroudi

Amlashi

Emami

2013

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…[7][8][9][10] There is sizeable literature describing the association of ovarian cyst with severe primary hypothyroidism. Case reports published by Hedayati et al, [11] Akbay et al, [12] Dietrich et al, [13] Lussiana et al, [14] Edwards et al, [15] Borna et al [16] and Mousavi et al [17] are few among them. In all these case reports, the ovarian cyst was regressed on administration of thyroid hormone.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Ovarian Cyst in Hypothyroidism: An Institutional Study

Ramesan¹,

Unnikrishnan²,

Firozbabu³

2016

jebmh

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BACKGROUND Primary hypothyroidism is the decrease in production and secretion of thyroid hormones by the thyroid gland. This is characterised by slackening of metabolism and leading to multiple system impairment. The important aetiological factors for primary hypothyroidism are congenital, iodine deficiency, autoimmune thyroiditis and iatrogenic. [1] Ovarian cysts are a common cause for gynaecological surgeries. The aetiology [2] of ovarian cysts can vary greatly including benign or malignant tumours, endometriosis and inflammation, etc. However, some cysts are direct result of endocrine disorders and do not require surgery. Hypothyroidism may cause reproductive and endocrinological disorders as well. The aetiopathogenesis is complex. In 1960 Van Wyk and Grumbach first described the relation between ovarian cyst and hypothyroidism. They proposed that there was a hormonal overlap in the pituitary feedback mechanism. It is due to the fact that TSH, GH, FSH and LH are all glycoproteins with a common alpha chain and may thus cross react. High TSH could produce FSH and LH like activity leading to luteinised ovarian cyst. The TRH may also act on pituitary cells to stimulate gonadotropin release and hence FSH and LH. Other postulated mechanisms are increased ovarian sensitivity to gonadotropins, altered metabolism of oestrogen, hypothalamopituitary dysfunction and altered prolactin metabolism. AIMS To study the percentage of ovarian cyst among the diagnosed cases of primary hypothyroidism and then to find out the association between hypothyroidism and ovarian cyst. To study the relation between level of TSH and size of ovarian cyst. To study the percentage of ovarian cyst among patients with TSH <50 mIU/L between 50-100 and >100 mIU/L separately.

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Imaging of complications following treatment with assisted reproductive technology: keep on your radar at each step

Srisajjakul

Prapaisilp

Bangchokdee³

2021

Abdom Radiol

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Ovarian Hyperstimulation Syndrome and Autoimmune Primary Hypothyroidism in Two Members of a Family

Cited by 8 publications

References 23 publications

Ovarian cyst regression with levothyroxine in ovarian hyperstimulation syndrome associated with hypothyroidism

Ovarian cyst regression with levothyroxine in ovarian hyperstimulation syndrome associated with hypothyroidism

Incidence of Ovarian Cyst in Hypothyroidism: An Institutional Study

Imaging of complications following treatment with assisted reproductive technology: keep on your radar at each step

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